Medical OPD Research Articles

Morbidity patterns in elderly patients attending medicine department of tertiary care center

Background: In India, there is a rapid increase in people above 60 years. In Rajasthan, there is increase in population of persons above 60 years from 5.1% of total population in 1961 to 7.2% in 2011. With increase in their number, the illnesses affecting elderly people will also increase. With this background, this study was done to assess the morbidity patterns in elderly population attending Department of Medicine, S.M.S. Medical College, Jaipur, Rajasthan, India.Methods: This was a cross sectional, prospective and observational study done in medicine department. 250 patients of 60 years and above, attending medical OPD or admitted were included. All data collected were entered in Microsoft Excel sheets and analysed statistically.Results: Respiratory diseases (45.6%) were commonest morbidity followed by cataract (36.8%), cardiovascular (34.4%) and hearing impairment (33.2%). Osteoarthritis was seen in 31.2% and anaemia was present in 20.8%. As the age increases chances of getting morbidities were more. The average number of illnesses per morbid person was 1.92.Conclusions: A high prevalence of morbidity among elderly highlights the urgent need to provide geriatric health care services in the developing country like India. Elderly persons should be motivated to undergo regular health check-ups to identify these common problems at earliest.

Apolipoprotein B levels and its relation to lipid profile in type II - Diabetes Mellitus; Comparative study

Background Type 2 diabetes mellitus is not only associated with carbohydrate metabolic disturbances but also been associated with dyslipidemia comprising of multiple lipoprotein disorders which increases the risk of cardiovascular morbidity and mortality. Apolipoprotein A-1 Apo A1 and apolipoprotein B Apo B are the main structural proteins of the circulating HDL particles and atherogenic lipoproteins respectively. Since apo B is the major apoprotein content of the atherogenic lipoprotein study of apo B levels may help in identifying diabetics who are at risk of developing cardiovascular morbidity even before there is alteration in the levels of LDL and HDL cholesterol.Objectives 1 To estimate serum total cholesterol triglycerides HDL cholesterol LDL cholesterol and Apo B levels in type 2 diabetes mellitus and comparing them with controls 2 To correlate the Apo B levels with total cholesterol triglycerides HDL cholesterol and LDL cholesterol in cases of type 2 diabetes and controls.Methods Subjects were from the patients attending Medical OPD amp Diabetology OPD of R.L.Jalappa Hospital and Research Centre Kolar. The subjects of either sex within the age group of 40 to 65 years were included for the study its Comparative study Sample size of 45 and divisions of following groups were made Group A - Proven cases of Type 2 diabetes mellitus under poor control Group B - Diabetic Controls Type 2 diabetes mellitus patients under control based on glycated hemoglobin levels amp Group C - Normal Healthy Controls.Results The levels of apo B is found to be increased in uncontrolled diabetes patients compared to the controlled diabetics and healthy controls. Correlation of Apo B showed a positive significant correlation with total cholesterol and LDL cholesterol in all the groups.Conclusion Apolipoprotein estimations give more insight to on-going metabolic changes occurring with circulating lipids. Lipid alterations are reflected better by Apo B estimation in type 2 diabetes mellitus and predicts the risk of associated complications with it.

BMI TO BLOOD PRESSURE

Objectives: To establish association of BMI, hypertension and ethnicity. StudyDesign: Observational cross sectional survey. Setting: Patients attending medical OPD of JinnahMedical College Hospital Korangi, Karachi. Period: April 2014 to December 2014. Methods:Blood pressure was measured and BMI calculated. The WHO recommended BMI cut off pointsfor South Asians were applied, overweight or obese were with a BMI of >23 kg/m2 or >27.5 kg/m2 respectively. Cardiometabolic risk factors Diabetes and hypertension were recorded. SPSSVersion 20 was used to analyze data. Results: Of n= 420 (100%) patients n= 130 (31%) weremales and n=290 (69%) females. Mean age was 36.37 SD±12.98 years (CI 35.13-37.61)Overweight (BMI 23-<27 kg/m2) were n=124(29.5%), and obese (BMI>27.5 kg/m2)) weren=83 (19.8%). There were 6 major ethnic groups. Mean BMI>24kg kg/m2 was present infemales of all ethnic groups. Normal diastolic blood pressure in females was higher thanmales in all ethnic groups except Urdu speaking p-value 0.000 Hypertension prevalencen= 98(23.3%) showed significant differences (p-value 0.039) in ethnic groups, with highestprevalence in SindhI n=10(30%) Urdu speaking n=27(27.8%), Punjabi n=14(26.9%), ofthese n=66(69.3%) were overweight and n=37 (41.1%) obese p-value 0.000. There was asignificant relationship between BMI and hypertension in overweight and obese males andfemales’ p-value 0.000 and 0.028 respectively. Conclusion: Significant relationship of BMI tohypertension and ethnic differences in prevalence of hypertension exists. Mean BMI in femalesis in the overweight category. Females have significant higher diastolic blood pressure thanmales in all groups except Urdu speaking; Intervention for prevention of obesity and reducingchronic disease burden needs to be urgently addressed.

A Correlative Study of Serum Homocysteine with Serum Lipid Profile in Young Adult Hypertensive Patients in Indian Population

Background: Hypertension and dyslipidemia are major risk factors for cardiovascular disease (CVD) and a leading cause of morbidity and mortality in both developed and developing countries. The prevalence of hypertension is projected to increase globally, especially in the developing countries. In recent years, rapid urbanization, unhealthy diet and lifestyle changes have led to an increased rate of CVD. Hyperhomocysteinemia (HHcy) has been regarded as a new risk factor related to hypertension. An elevated homocysteine level induces thrombogenicity, causes procoagulant state and promotes the proliferation of smooth muscle cells, which could lead to vascular constriction and stiffness. Our study was aimed to find out the status of serum homocysteine and serum lipid profile in hypertensive and normo- tensive subjects & correlation of serum homocysteine with serum lipid profile in hypertensive subjects. This study was limited and this topic needs to be further worked upon. Materials and Methods: The present study was conducted on 100 patients with essential hypertension who attended the medical OPD of Jawahar Lal Nehru Medical College and Associated Group of Hospital, Ajmer. The results of patients were compared with 50 normotensive subjects. Anthropometric para- meters and biochemical estimation were performed after taking approval from Ethical Committee. The serum total cholesterol (TC), triglyceride (TG) and HDL cholesterol (HDLC) were determined enzymatically, while LDL cholesterol (LDLC) was calculated using the Friedewald formula & serum homocysteine was determined by ELISA technique. Results: The mean serum level of homocysteine was elevated in hypertensive subjects as compared to normotensive subjects and was highly significant (P<0.0001). The mean values of serum TC, TG and LDL-C were significantly higher and statistically significant among the hypertensive patients compared to normotensive subjects & the mean HDL –C level was lower in the hypertensive subjects compared to normotensive subjects and was statistically significant. The present study has also shown the positive correlation between serum homocysteine and serum TC, TG and LDL-C & negative correlation between serum homocysteine and HDL-C in hypertensive subjects. Conclusion: The observations of this study have revealed that there was significant alteration of serum homocysteine, cholesterol, triglyceride, HDL cholesterol and LDL cholesterol in hypertensive patients. Therefore, for routine monitoring of hypertensive patients to prevent the coronary heart disease (CHD) and other consequences, the reinforcement of these parameters may be recommended in daily clinical practice.

OBESITY

Objectives: The main aim of the study was to evaluate the association betweenserum Vitamin D levels with Obesity. Study Design: Case-Control study. Place of Study:Department of Medical OPD Liaquat Medical University Hospital, Jamshoro/Hyderabad,Sindh, Pakistan. Duration of Study: June 2015 to December 2015. Material &amp;Method: Total200 subjects including 100 Non obese as control group &amp; 100 obese subjects participatedvoluntarily in this study. This study was conducted in Medicine Department of Liaqat UniversityHospital Jamshoro/Hyderabad. Serum Vitamin D Levels were measured by commerciallyavailable kit. Results: This research found that the serum vitamin D levels are less in obesepersons as compared to non-obese people. Conclusion: Vitamin D levels are less in obesewhen compared to non-obese.

Status of Serum Gamma GlutamylTranspeptidase and Serum Homocysteine in Young Adults with Essential Hypertension

Background: Hypertension is recognized as the most common cause of cardiovascular disorder and a leading cause of morbidity and mortality in both developed and developing countries. Gamma-glutamyl transpeptidase is serum transferase enzyme synthesised by liver. It is commonly used in clinical practice to monitor liver function, hepato-biliary disorders and as a marker of alcohol intake. It has been proposed that gamma glutamyl transpeptidase is a potent preclinical marker of atherosclerosis. Hyperhomocysteinemia (HHcy) has been regarded as a new risk factor related to hypertension. Our study was aimed to find out the status of serum gamma glutamyl transpeptidase and homocysteine in hypertensive and normotensive subjects & Correlation of serum GGT with serum homocysteine in hypertensive subjects. Materials and methods: The present study was conducted on 100 patients with essential hypertension who attended the medical OPD of Jawahar Lal Nehru Medical College and Associated Group of Hospital, Ajmer. The results of patients were compared with 50 normotensive subjects. Anthropometric parameters and biochemical estimation were performed after taking approval from Ethical Committee. The Serum GGT was measured by colorimetric kinetic assay and Serum Homocysteine was measured by ELISA technique. Results: The mean serum level of GGT was elevated in hypertensive subjects as compared to normotensive subjects (controls) and was statistically significant (P<0.001). The mean serum level of Homocysteine was elevated in hypertensive subjects as compared to normotensive subjects and was highly significant (P<0.0001).The present study has also shown a positive correlation (r=0.74) between serum GGT & serum homocysteine in hypertensive subjects. Conclusion: The present study shows that the level of both, serum GGT and serum homocysteine is raised in young adult patients with essential hypertension and has also shown a positive correlation between serum GGT & serum homocysteine in these subjects. Thus the elevated GGT and Homocysteine in young adults may contribute to their susceptibility to hypertension and provide an additional evidence of novel role of GGT and Homocysteine in cardiovascular risk evaluation. This study was limited and needs to be further worked upon.

DIABETIC PATIENTS

Objectives: The aim of study was to measure the prevalence depressionlevel in diabetic patients. Sample and studied sources: Total sixty patients were randomlywho a in medical OPD with diabetes both male and female patients were included in studyformal approval was taken from hospital administration. Hypothesis: Depression level maybe height in diabetic patients after taking informed consent patients were interviewed. Period:Data collection was completed during May to June, 2014. Material and method: Depressioncan be measured by use Beck depression inventory, a structured psychiatric diagnostic toolafter which the diagnosis can be made according to criteria of the Diagnostic and StatisticalManual of Psychiatric Disorders (DSM IV). However, these interviews are time consuming; formy population it’s difficult to understand the English there for patient convert question wereasked in Urdu these questionnaires are often used as a screening instrument. DemographicInterview form: Demographic personal information was obtained through items which focuson subject name, father name, age, gender marital status education, occupation, sibling, familystructure, family history of disease, random blood sugar, fasting blood sugar, duration of illnessand other complication. Beck’s Depression Inventory Results: The statistics analysis revealedthat depression level is high in diabetic patients. Correlation is significance at 0.05.

English

Objective and aims: To determines relationship of age, gender, hypertension, diabetes mellitus and obesity with primary and secondary headache in a tertiary care hospital. Study design: A cross-sectional study. Place and duration of study: Medical OPD of Liaquat University of Medical and Health Sciences, Hyderabad from 10January to 10 July 2015. Methodology: Patients (male and female) with complaint of headache in medical OPD were included in this study. Patients with acute emergency, stroke, meningitis, encephalitis and severe infection were excluded. After taking informed consent, history, examination and laboratory test (like fasting blood glucose, blood urea nitrogen) were sent. Data was recorded in a proforma. Data was entered and analyzed using SPSS version 20. Results: A total of 100 patients of headache were included in this study. The mean age of enrolled participants was 33.6±2 years. Forty percent were male and 60% female with male to male ratio was 0.7:1. Eighty nine percent of patients have normal blood pressure, 82% normal blood sugar and 48% normal body mass index. Eighty six percent patients had primary and 14% had secondary headaches. Normal blood pressure was observed in 93% cases of primary headache compared to 64.3% in secondary headache (p-0.006). Normal blood sugar was observed in 14% cases of primary headache compared to 42.9% in secondary headache (p-0.018).normal body mass index was observed in 51.2% cases of primary headache compared to 28.6% in secondary headache (p- 0.002). Conclusion: There is strong relationship of primary headache with age, gender, obesity but not associated with hypertension and diabetes mellitus. Hypertension and diabetes are more strongly related with secondary headache

English

Objectives: The aim of study was to measure the prevalence depression level in diabetic patients. Sample and studied sources: Total sixty patients were randomly who a in medical OPD with diabetes both male and female patients were included in study formal approval was taken from hospital administration. Hypothesis: Depression level may be height in diabetic patients after taking informed consent patients were interviewed. Period: Data collection was completed during May to June, 2014. Material and method: Depression can be measured by use Beck depression inventory, a structured psychiatric diagnostic tool after which the diagnosis can be made according to criteria of the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM IV). However, these interviews are time consuming; for my population it's difficult to understand the English there for patient convert question were asked in Urdu these questionnaires are often used as a screening instrument. Demographic Interview form: Demographic personal information was obtained through items which focus on subject name, father name, age, gender marital status education, occupation, sibling, family structure, family history of disease, random blood sugar, fasting blood sugar, duration of illness and other complication. Beck's Depression Inventory Results: The statistics analysis revealed that depression level is high in diabetic patients. Correlation is significance at 0.05.

CHRONIC HEPATITIS C

The major causative factor of hepatic cirrhosis and its complications in chronichepatitis C is due to presence of liver fibrosis. To assess prognosis and management relateddecisions, the exact staging of liver fibrosis is of greatest importance. Now, liver biopsyis the inexact gold standard for this purpose. APRI or AST to platelet ratio Index is the bestnoninvasive marker which can predict presence of fibrosis in majority of chronic hepatitis Cpatients without the need of biopsy. It is also cost effective and only depends on routine testing(Platelet count and serum AST). Objectives: To determine the positive predictive value ofAPRI Score for the prediction of fibrosis and cirrhosis in chronic hepatitis C patients. Studydesign: Cross sectional study. Setting: Medical wards and Out Patient Medicine Departmentof Liaquat University Hospital Hyderabad / Jamshoro. Period: 6 months. Methodology: A totalof 51 patients of either gender, age &gt;14 years presenting to Medical wards and OPD for theevaluation of chronic hepatitis were enrolled in this research study after giving preference andavoiding criteria. Clinical data was collected at the time of liver biopsy and blood samples forliver function tests, blood glucose and complete blood picture with platelet count were collectedbefore the biopsy (only AST and platelet count are needed for APRI score) a core biopsy needleof 14 gauge was used and the procedure was conducted under ultrasound guidance. Fibrosisstage was determined according to the METAVIR group scoring system. The patients wereexamined in a very comfortable manner and all the information collected from the patients waskept confidential and entered in the predesigned proforma. Results: A total of 51 patients wereselected for this study. Out of these 31 (60.78%) were male and 20(39.22%) were female. Themean age was 42.53 years (±11.2 SD). The positive predictive value for APRI score between0.5 to 1.0 was 58.82% whereas the positive predictive values for APRI score 1.1-1.5 was 70.58%.Conclusion: The positive predictive values of APRI score in the ranges of 0.5 to 1.5 were notindicative of the presence of significant liver fibrosis in this research study. However, additionaldata are required to authenticate or disprove the usefulness of APRI score for the prediction ofsignificant hepatic fibrosis in chronic hepatitis C patients.

Complementary and alternative medicine use in medical OPD patients of rheumatoid arthritis in a tertiary care hospital

Background: Complementary and alternative medicine (CAM) use is high among chronic illness like arthritis to derive additional benefits. Aim and Objective: To examine CAM use among rheumatoid arthritis (RA) patients. Materials and Methods: The study was conducted in 100 patients having rheumatoid arthritis reporting to medical OPD of tertiary-care hospital. Patients were asked to respond to a predesigned questionnaire pertaining to demographic profile and CAM usage. Result: CAM use was high among RA (60%) patients more so with longer duration of disease (81.66%). Majority of patients were from rural background (80%) above 40 years age (87%) and were females. Of all, 75% patients took to CAM after anti-rheumatoid drugs and lack of relief was the main reason. Ayurveda was most common type of CAM (35%) used and relatives were the principal source of information (58.33%). Most of the patients (61.66%) of rheumatoid arthritis reported relief with CAM. Conclusion: CAM use is high among RA patients especially in females and patients with longer duration of disease. Lack of benefit from anti-rheumatoid drugs was the main reason of CAM usage. Ayurveda was the most common type of CAM used. Therefore, the outcome of the study calls for the attention of treating physician regarding CAM use as some orally used CAM therapies can be harmful due to possibility of interactions and heavy metals.

English

The major causative factor of hepatic cirrhosis and its complications in chronichepatitis C is due to presence of liver fibrosis. To assess prognosis and management relateddecisions, the exact staging of liver fibrosis is of greatest importance. Now, liver biopsyis the inexact gold standard for this purpose. APRI or AST to platelet ratio Index is the bestnoninvasive marker which can predict presence of fibrosis in majority of chronic hepatitis Cpatients without the need of biopsy. It is also cost effective and only depends on routine testing(Platelet count and serum AST). Objectives: To determine the positive predictive value ofAPRI Score for the prediction of fibrosis and cirrhosis in chronic hepatitis C patients. Studydesign: Cross sectional study. Setting: Medical wards and Out Patient Medicine Departmentof Liaquat University Hospital Hyderabad / Jamshoro. Period: 6 months. Methodology: A totalof 51 patients of either gender, age &gt;14 years presenting to Medical wards and OPD for theevaluation of chronic hepatitis were enrolled in this research study after giving preference andavoiding criteria. Clinical data was collected at the time of liver biopsy and blood samples forliver function tests, blood glucose and complete blood picture with platelet count were collectedbefore the biopsy (only AST and platelet count are needed for APRI score) a core biopsy needleof 14 gauge was used and the procedure was conducted under ultrasound guidance. Fibrosisstage was determined according to the METAVIR group scoring system. The patients wereexamined in a very comfortable manner and all the information collected from the patients waskept confidential and entered in the predesigned proforma. Results: A total of 51 patients wereselected for this study. Out of these 31 (60.78%) were male and 20(39.22%) were female. Themean age was 42.53 years (±11.2 SD). The positive predictive value for APRI score between0.5 to 1.0 was 58.82% whereas the positive predictive values for APRI score 1.1-1.5 was 70.58%.Conclusion: The positive predictive values of APRI score in the ranges of 0.5 to 1.5 were notindicative of the presence of significant liver fibrosis in this research study. However, additionaldata are required to authenticate or disprove the usefulness of APRI score for the prediction ofsignificant hepatic fibrosis in chronic hepatitis C patients.

Expression of REG Iα gene in type 2 diabetics in Pakistan.

BackgroundThe escalating rate of diabetes’ has prompted researchers around the world to explore for early markers. A deficit of functional β-cell mass plays a central role in the pathophysiology of type 2 diabetes. The REG (Regenerating) gene, encoding a 166 amino acid REG protein was discovered in rats and humans which is released in response to β-cells damage and play a role in their regeneration. The objective of this study was to characterize serum levels of REG Iα proteins in type 2 diabetic patients as indicator of β-cell apoptosis as well as regeneration.MethodsUnrelated type 2 diabetic patients (n = 55) of different age groups and disease duration were recruited from the Medical OPD of PNS Shifa Hospital. Age and sex matched non diabetic controls (n = 20) without family history of diabetes were selected from the same setting. Demographical details were recorded on a structured questionnaire. Biochemical parameters like FBG, HbA1c, TC and TG levels were measured. Serum levels of REG Iα protein were determined by ELISA.ResultsLevels of REG Iα protein were found significantly raised in type 2 diabetic patients compared to controls (p < 001). Patients with short duration of the disease had higher levels of REG Iα as compared to patients with longer duration of the disease. Although the patients were on anti hyperglycemic agents, a positive correlation was found between REG Iα serum levels, FBG and HbA1c levels. Patients with higher BMI had higher levels of serum REG Iα levels. Serum TC, TG and Hb levels showed no correlation.ConclusionREG Iα may be used as a marker/predictor of type 2 diabetes especially in the early stages of the disease.

HYPERTENSION

Objectives: To assess awareness about Hypertension among patients. Studydesign: Cross-sectional Survey. Setting: Medical OPD at Rawal General Hospital, Islamabad.Period: Three months from 1st April to 30th June. Materials and Methods: A total of 150 male,female patients attending Medical Out Patient Department at Rawal General Hospital Islamabadwere assessed regarding awareness about Hypertension using a self-constructed mixedquestionnaire (In English and Urdu). Results: Following findings were observed among patientsattending RGH, Islamabad: 82% of patients found to have family history of HTN, while 13%responded negative. 5% of the patients were unaware. 33% of patients found to have diabetesmellitus, while 29% responded negative and 38% of the patients were unaware of having or not.Hypertensive population found to be 51%. 45% found to adhering to anti-hypertensive treatment,while 55% responded negative. 80.6%, 90%, 73%, 82% and 85% considered the obesity, lackof exercise, cigarette smoking, anxiety and high cholesterol respectively as causative factor ofHTN. Excessive intake of salt was considered by 84% as causative factor of HTN. About 82%considered DM as causative factor of HTN. 79%, 73%, 93%, 55% of the patients considered thecardiac disease, renal failure, brain hemorrhage and loss vision respectively as complicationof HTN. 80%, 90%, 73%, 27% consider the regular exercise, reduced salt intake, no smoking,keeping weight under control respectively as preventive measures of HTN. About half and morethan half of the respondents considered frequent use of vegetables, excessive intake of sweets,as preventive measures of hypertension. Conclusions: The assessment of awareness aboutHypertension among population of various areas can be beneficial in effective planning fordisease prevention and control.

English

Objectives: To assess awareness about Hypertension among patients. Studydesign: Cross-sectional Survey. Setting: Medical OPD at Rawal General Hospital, Islamabad.Period: Three months from 1st April to 30th June. Materials and Methods: A total of 150 male,female patients attending Medical Out Patient Department at Rawal General Hospital Islamabadwere assessed regarding awareness about Hypertension using a self-constructed mixedquestionnaire (In English and Urdu). Results: Following findings were observed among patientsattending RGH, Islamabad: 82% of patients found to have family history of HTN, while 13%responded negative. 5% of the patients were unaware. 33% of patients found to have diabetesmellitus, while 29% responded negative and 38% of the patients were unaware of having or not.Hypertensive population found to be 51%. 45% found to adhering to anti-hypertensive treatment,while 55% responded negative. 80.6%, 90%, 73%, 82% and 85% considered the obesity, lackof exercise, cigarette smoking, anxiety and high cholesterol respectively as causative factor ofHTN. Excessive intake of salt was considered by 84% as causative factor of HTN. About 82%considered DM as causative factor of HTN. 79%, 73%, 93%, 55% of the patients considered thecardiac disease, renal failure, brain hemorrhage and loss vision respectively as complicationof HTN. 80%, 90%, 73%, 27% consider the regular exercise, reduced salt intake, no smoking,keeping weight under control respectively as preventive measures of HTN. About half and morethan half of the respondents considered frequent use of vegetables, excessive intake of sweets,as preventive measures of hypertension. Conclusions: The assessment of awareness aboutHypertension among population of various areas can be beneficial in effective planning fordisease prevention and control.

Un-Diagnosed Depression with Suicidal Ideation/Intent among Patients Visiting Medical OPD: Depression in Disguise

Objective: This study was aimed to calculate the prevalence rate of suicide among the patients who regularly visit medical outdoor with psychosomatic complaints. Method: We have selected 750 patients around the country and screened them for depression and suicide. Result: Data shows that the prevalence of suicide is 14.7% per 10,000 persons and rate of depression is 21.8% per 10,000 persons. Preliminary analysis shows the significant correlation between the variables (0.284**), descriptive statistical analysis yielded gender (0.00), age (0.02) and employment (0.05) as a significant contributing factors towards suicide behavior. Conclusion: It is verdict that the health professionals should have in-depth consideration to the symptoms and should investigate about the patients’ psychological well-being.

HYPERTENSION

Hypertension is a common term to define a state of raised blood pressure, and theraised blood pressure is 140 mm Hg mean systolic blood pressure of and mean diastolic bloodpressure of at least 90 mm Hg. Objectives: To assess awareness about Hypertension amongpatients attending Medical OPD at THQ Hospital Hassan Abdal. Materials and Methods: A totalof 150 male, female patients belonging to both rural and urban areas attending Medical OutPatient Department at THQ Hospital Hassan Abdal using a self constructed mixed questionnaire(In English and Urdu). Results: Following findings were observed among patients attendingTHQ hospital, Hassan Abdal: Family history of HTN was found to be 49% and 26% was unawareof family history of HTN. 33% found to have diabetes, 38% were unaware of having or not.29.3% found to have HTN, 48.6% were unaware of having HTN or not. 34% of hypertensivepatients showed compliance to the anti-hypertensive treatment while (66%) showed noncompliance.60.6%, 78%, 62%, 74%, 68% considered the obesity, lack of exercise, cigarettesmoking, anxiety and high cholesterol respectively as causative factor of HTN. Excessive intakeof salt was considered by 56% as causative factor of HTN. 29% considered diabetes Mellitus ascausative factor of HTN. 42%, 31%, 46% and 34% considered the cardiac disease, renal failure,brain hemorrhage and loss vision respectively as complication of HTN. Stroke was consideredcomplication by (54%). 55%, 65%, 53% and 58% considered the regular exercise reduced saltintake, no smoking and keeping weight under-Control respectively as preventive measures ofHTN. Less than half of the respondents considered frequent use of vegetables, excessive intakeof sweets, as the preventive measures of HTN. Conclusions: The assessment of awarenessabout Hypertension among population of various areas can be beneficial in effective planningfor disease prevention and control.

Biochemical role of serum fructosamine in patients with thyroid disorders

Background: Fructosamine (FA) is the product of a reaction between glucose (sugar) and albumin (protein). It is used to monitor the short-term glycemic changes in patients with diabetes and may have a role in conjugation with glycated hemoglobin. Aims & Objective: Fructosamine test is used to evaluate the average amount of glucose in blood over a period of 2–3 weeks. FA is a useful indicator to measure the peripheral metabolic function in patients with thyroid disorders. As serum thyroid function tests, fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), serum FA ratios occupied our attention, their inconsistency in the subjects with subclinical hypothyroidism, overt hypothyroidism, and hyperthyroidism in relation to the euthyroid healthy control subjects was studied here. Materials and Methods: This study was conducted on 100 patients with overt hypothyroidism, subclinical hypothyroidism, and hyperthyroidism attending the medical OPD and radioimmunoassay laboratory of the Department of Biochemistry, Jawaharlal Nehru Medical College and Hospital, Ajmer, Rajasthan, India. Results: The mean glycated hemoglobin level was higher in study group than in controls, and it was not statistically significant. The mean serum FA level was higher in patients with overt hypothyroidism and subclinical hyperthyroidism and lower in those with hyperthyroidism than that in controls. It was found to be highly statistically significant. Conclusion: The FA values, which are largely higher than FPG and HbA1c values, indicate a higher propensity to glycation and a decrease turnover of the proteins in the patients with overt hypothyroidism and subclinical hypothyroidism; contrary results were observed in individuals with hyperthyroidism.

Study of association of metabolic syndrome and its components in premenopausal and postmenopausal Indian females

Background: The metabolic syndrome (MS) consists of constellation of metabolic abnormalities that increases the risk of cardiovascular diseases (CVD) and diabetes mellitus.Studies show that CVD is one of the major causes of death in postmenopausal women. Our aim was to study the association of Metabolic Syndrome and its components in premenopausal and postmenopausal Indian females. Methods: It was an Observational study. We enrolled 100 females who came to medical OPD. Out of 100 females enrolled, 49 were in premenopausal stage (Group I) and remaining 51 had attained menopause (Group II). Results: Age of a woman ranged from 22 to 72 years with a mean age of 41.94 ± 11.33 years. According to IDF criteria, 76.5% of postmenopausal women had MS compared to 51.0% of premenopausal women (P = 0.008). Waist circumference (P = 0.027) as well as WHR was significantly higher in Group II. Regular physical activity was higher in Group I (38.8%) as compared to Group II (27.5%) but the difference was not significant statistically. Majority of women in both the groups were vegetarians, statistically there was no significant difference between groups with respect to dietary preference (P = 0.139). Mean total cholesterol levels, VLDL, triglyceride, LDL, Fasting blood sugar levels were higher in Group II, however, the difference was significant statistically with respect to total cholesterol and LDL only. Conclusions: In our study, menopause, diet and exercise were found to be significantly associated with MS. Diet and exercises are the modifiable risk factors that can be modified by restricting calories and increasing physical activity.

PERCEPTION REGARDING FEMALE FETICIDE AMONG FEMALES ATTENDING OUT PATIENT DEPARTMENTS OF SELECTED HOSPITAL OF LUDHIANA CITY

Abstract Background: Although the Indian girl child's position is precarious throughout the country, she remains the most vulnerable in Punjab. Objectives: To assess the perception of females regarding female feticide. Study Design: Cross- sectional study. Materials and Methods: The study involved collection of information regarding perception of females about female feticide using multiple-choice questionnaire. Two hundred and fifty female patients attending medical and surgical OPD's of selected hospital were recruited in the study by using simple random sampling. Results: Majority of the females perceived that male child is more preferred in society. Moreover, majority of subjects have the view that female feticide has harmful impact on the society and should be stopped. The suggestion given by subjects to curb this evil practice included enforcement of strict laws, punishment to people and doctor involved and creating awareness regarding the issue.