C4d deposition in native kidney disease and its correlation with proteinuria and serum urea/creatinine

Background: C4d is a well-known biomarker of the complement cascade. It is derived from cleavage of the labile thioester bond of C4b. This cleavage provides C4d a covalent bond which helps C4d to anchor to nearby cells where immune complexes are deposited. Antibodies dissociate naturally because of relatively weak hydrostatic and Van der Waals forces between antigens and antibodies, whereas covalent bond of C4d has a much longer half-life. For this reason, C4d serves as a footprint of complement activation.Methods: This was a retrospective and prospective cross-sectional study, done at our tertiary care hospital.Results: Authors evaluated 50 cases and 10 controls to adjudge the significance of C4d deposits in native renal diseases. Majority of the patients (44%) were in the age group of 10-20 years followed by 20% in the age group of 31-40 years. 62% of study population were male. Majority of patients were diagnosed with FSGS (16%), followed by membranous nephropathy (14%), lupus nephropathy (14%) and IgA nephropathy (12%). There was correlation of intensity expression of glomerular C4d deposits with presenting 24 hours urinary protein level at the time of biopsy (p value=0.027) but no correlation with urea/creatinine.Conclusions: All patients diagnosed with membranous nephropathy, IgA nephropathy and hypertensive nephropathy showed glomerular C4d deposits, and also diagnosed with IgA nephropathy, post infectious glomerulonephritis, lupus nephritis, minimal change disease, acute/chronic tubulointerstitial nephritis, diabetic nephropathy, hypertensive nephropathy showed tubular C4d deposits. All patients diagnosed with diabetic nephropathy and hypertensive nephropathy showed arterial C4d deposits.

Download Full-text

COMPARATIVE EVALUATION OF SPIROMETRY PARAMETERS IN HEALTHY YOUNG AND ELDERLY ADULTS POPULATION IN PUNJAB, INDIA

10.36106/ijar/5406276 ◽

2021 ◽

pp. 1-3

Author(s):

Ajay Pal Singh ◽

Kailash Meena ◽

Surinder Pal Singh ◽

Avnish Kumar ◽

Ashish Shukla ◽

...

Keyword(s):

Pulmonary Function ◽

Tertiary Care ◽

P Value ◽

Pulmonary Medicine ◽

Care Hospital ◽

Age Group ◽

Elderly Adults ◽

Elderly Age ◽

Cross Sectional ◽

Age Related

INTRODUCTION: Spirometry is a vital tool for the assessment of pulmonary function status. Spirometry can be used to demonstrate the age-related decline in pulmonary function. The spirometry values can be used as reference values for a particular age group. The aims of our study was to compare spirometry values between the young and elderly groups and evaluate age-related changes in both groups. MATERIAL AND METHODS: A cross-sectional study was conducted on 600 adults, which divided into two healthy groups: one was of young adults (18-35 years), and other was of elderly adults (>60 years) of 300 persons, each taken over a period of one year, in the Department of pulmonary medicine, a tertiary care hospital, Punjab. We conducted spirometry in both age group. Spirometry values were measured FVC, FEV1, FVC/FEV1, PEFR, and FEF25- 75 % of each groups.The subjects were selected based on random sampling RESULT: Spirometry values compared between young and elderly adults. Mean BMI in young and elderly groups was 25.09±2.87 and 25.82±2.45, respectively. Spirometry values in FVC , FEV1, FEV1/FVC , PEFR and FEF25-75% in young was 4.31± 0.18 , 3.84,± 0.88± 0.02, 9.87± 0.38 and 3.75 ±0.26 and elderly age group 3.01±, 2.60 ±0.85± 0.02, 7.70± 0.30 and 2.82 ± 0.26. On statistical analysis, p value <0.001 in all spirometry parameters. CONCLUSION: The study shows that there was a decline in spirometry parameters of healthy adults with the increase in age. This decline was signicant in all spirometric parameters (FVC, FEV1, FEV1/FVC, PEFR, FEF25–75%) measured in the present study

Download Full-text

Clinico-biochemical profile of chronic kidney disease patients in elderly age group in a tertiary care centre

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20194997 ◽

2019 ◽

Vol 7 (11) ◽

pp. 4227

Author(s):

Atul V. Rajkondawar ◽

Amit Yele

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Elderly Patients ◽

Tertiary Care ◽

P Value ◽

Age Group ◽

Elderly Age ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Significant Difference

Background: Chronic kidney disease (CKD) remains one of the major health problems in India. Renal function steadily deteriorates as age advances and advancing age has been indicted to have adverse implications in the disease progression to end stage renal disease (ESRD). With the present study, clinico-biochemical profiling of chronic kidney disease patients in geriatric age group as well as comparison with non-elderly patients was undertaken.Methods: In this cross-sectional observational study, 100 patients of CKD admitted in the tertiary care study centre were enrolled consecutively and assessed for symptoms, signs and biochemical parameters over two years. Study subjects were divided into two groups:- Group 1: Elderly patients- aged 60 years or more, and Group 2: Non-elderly patients- less than 60 years of age. Relevant comparisons were drawn statistically and tested for significance.Results: Pallor and pedal edema were observed to be the commonest clinical features across groups. Elderly group shows higher prevalence of severe anaemia (mean hemoglobin- 7.4 gm%). Higher prevalence of clinical and biochemical derangement was found in patients with relatively lower GFR. Elderly age group also had more prevalence of electrolyte abnormalities compared with non-elderly population, with statistically significant difference observed for hyponatremia (p value- 0.023), hypoproteinemia (p value- 0.0078) and blood urea level (p value- 0.0054).Conclusions: Understanding beforehand the biochemical abnormalities associated with old age in CKD patients helps in appropriate modifications in patient management.

Download Full-text

Prevalence of refractive errors by age and gender in patients reporting to ophthalmology department.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.09.5216 ◽

2020 ◽

Vol 27 (09) ◽

pp. 1989-1994

Author(s):

Adeel Ahmed Siddiqui ◽

Muhammad Ajmal Chaudhary ◽

Muhammad Zafar Ullah ◽

Majid Hussain ◽

Nadeem Ahmed ◽

...

Keyword(s):

Tertiary Care ◽

Age Groups ◽

P Value ◽

Refractive Errors ◽

Care Hospital ◽

Age Group ◽

Ocular Surgery ◽

Cross Sectional ◽

Age And Gender ◽

And Gender

Objectives: To determine the age and gender specific prevalence of different refractive errors in the patients presenting to the Ophthalmology Departments of the tertiary care hospital. Study Design: Analytical Cross-sectional study. Setting: Departments of Outpatient Ophthalmology at THQ Hospital Kabirwala, The Children’s Hospital & The Institute of Child Health Multan and Nishtar Hospital, Multan. Period: January 2020 to May 2020. Material & Methods: A total of 400 patients ≥ 4 years age of either gender were included. Patients with history of ocular surgery, trauma and advanced fundus disease were excluded. Age and gender of the patients was noted. Clinical examination and autorefraction were carried out. Quantitative data is presented as mean ± SD and qualitative data as frequency and percentages. Chi-square test is used to assess the association of refractive errors with age groups and gender. Results: Median age of the participants was 20 years (range 04 – 92 years). Males constituted 58% (n = 232) of the study participants. Most common refractive error were astigmatism (n=298, 74.5%) and myopia in 187 (46.75%) patients. Prevalence of myopia was significantly higher (p-value < 0.001) in 11-20 (39.6%) and 21-40 (34.2%) years age group and in males (64.7%, p-value 0.01). Hypermetropia was significantly higher (p-value <0.001) in 4-10 (36.8%) and ≥ 41 (38.7%) years age group with no gender predilection. Conclusion: This study shows prevalence of myopia being highest in males age 11-40 years and prevalence of hypermetropia being highest in children between 4-10 year and elderly ≥ 41 year with no gender predilection.

Download Full-text

Socio-Demographic Characteristics of Blood Donor in a Tertiary Care Specialized Hospital

Bangladesh Journal of Medicine ◽

10.3329/bjm.v32i2.53798 ◽

2021 ◽

Vol 32 (2) ◽

pp. 113-119

Author(s):

Mohd Abul Quader

Keyword(s):

Blood Donors ◽

Blood Donation ◽

Tertiary Care ◽

Income Group ◽

Demographic Characteristics ◽

P Value ◽

Age Group ◽

College Hospital ◽

Cross Sectional ◽

Younger Age

Background: Blood donors are the backbone of a transfusion service. To ensure a safe and appropriate transfusion service, donor demography is to be optimized for proper strategic management. The purpose of this study was to assess the socio-demographic profile of blood donors to make targets for national interventions and to promote blood donation. Methods: This descriptive type cross sectional study was conducted in Transfusion Medicine department of Popular Medical College Hospital from 1st January 2015 to 30th June 2018. All the blood donors who came to donate blood in this department were included in this study. Their signed consent was obtained to include in this study with their socio-demographic determinants. Frequency, percentage and p value<0.05 were calculated for statistics. Results: Out of the 15702 blood donors, male donors were more with a ratio of 6.78:1. Though the younger age group (25-31 years) showed highest donor population (32.61%), but the younger age group (18-38 years) have maximum donation (86.21%). Unmarried donors were 59.07% among the donors and middle class income group also showed highest donors (59.09%). Student donors (30.55%) were more among the donors. Muslims donors (79.01%) were more than others religious donors. Regarding education level of donors, higher secondary and above level showed highest donation (90.97%) which was statistically significant (p<0.001). Among the donors 78.05% showed their future intension to donate. Conclusions: Works on differences in socio-demographic characteristics of blood donors in times of increasing demand appears to be fruitful to target national interventions and to promote blood donation. Bangladesh J Medicine July 2021; 32(2) : 113-119

Download Full-text

Recurrence rate of breast cancer after modified radical mastectomy at tertiary care hospital

10.53350/pjmhs2115102739 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2739-2741

Author(s):

Asiya Shabbir ◽

Shahid Hussain ◽

Muhammad Asif

Keyword(s):

Breast Cancer ◽

Recurrence Rate ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Radical Mastectomy ◽

P Value ◽

Care Hospital ◽

Age Group ◽

Modified Radical Mastectomy ◽

Cross Sectional

Objectives: To assess the recurrence rate of breast cancer after modified radical mastectomy in cases of breast cancer at tertiary care hospital. Material and methods: Between the March 2020 to September 2020 (over the period of 6 months) total 110 women with breast cancer having age range 30-60 years were recruited from Department of Surgery, Bahawal Victoria Hospital Bahawalpur for this cross sectional study. Modified radical mastectomy was performed in all selected patients. At 6 months follow up, all the selected patients was again examined for recurrence of breast cancer. Results: Total 110 patients with breast cancer were recruited. Mean age of the patients was 43.56 ± 8.9 years. Recurrence of breast cancer was found in 25 (23%) cases. Total 11 (10%) patients belonged to age group <30 years followed by 13 (11.82%) patients to age group 30-40 years, 41 (37.27%) to age group 41-50 years and 45 (40.91%) patients to age group 51-60 years. Recurrence of breast cancer was noted in 2 (18.18%) patients, 3 (23.08%) patients, 10 (24.39%) patients and 10 (22.22%) patients respectively. Statistically insignificant association of recurrence with age group was noted with p value 0.9776. Conclusion: Results of this study showed a higher rate of recurrence of breast carcinoma after modified radical mastectomy. Most of the patients belonged to 5th decade of life. Parity, educational status and marital status showed no association with recurrence of breast cancer.

Download Full-text

Causes of Epilepsy in Elderly Patients Presenting in a Tertiary Care Hospital of Karachi

Pakistan Journal of Medicine and Dentistry ◽

10.36283/pjmd9-4/009 ◽

2020 ◽

Keyword(s):

Elderly Patients ◽

Cerebrovascular Disease ◽

Neurodegenerative Disorder ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Traumatic Head Injury ◽

Keywords Epilepsy ◽

College Hospital ◽

Cross Sectional

Background: Epilepsy is fairly a frequent occurrence in the elderly. It is commonly diagnosed after the episode of two or more unprovoked seizures. Unprovoked seizures in elderly are recurrent rather than younger individuals. This study was designed to estimate the concrete burden of frequent causes of epilepsy. Methods: A descriptive cross-sectional study with a total of 153 patients diagnosed case of epilepsy were included in this study at Jinnah Medical College Hospital from February 2018-August 2018. Mean was calculated for age, duration of disease of the patients. Causes of epilepsy, gender, and education was calculated and presented as percentages. Electrolyte readings were taken i.e., Sodium, Calcium and Magnesium levels and imaging was planned to rule out stroke, primary neurodegenerative disorders and tumors. Post stratiﬁcation Chi square test was applied and p-value less than or equal to 0.05 was considered signiﬁcant. Results: The mean age of the patients was 63.91±5.68 years and mean duration of the disease was 4.61± 1.07 months. The common causes of epilepsy were found to be cerebrovascular disease 56.9%, cryptogenic 54.2%, neurodegenerative disorder 20.3%, traumatic head injury 11.8%, metabolic abnormalities or electrolyte disturbances 10.5% and brain tumor 7.8%. Conclusion: Elderly patients with ﬁrst seizure should present to a facility designed in a way that neurologist, cardiologist, rehabilitation and geriatrics work together to identify and treat the condition in a better way. Keywords: Epilepsy; Seizures; Cerebrovascular Disease; Neurodegenerative Disorder.

Download Full-text

Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

Bangladesh Journal of Child Health ◽

10.3329/bjch.v41i3.36951 ◽

2018 ◽

Vol 41 (3) ◽

pp. 159-164 ◽

Cited By ~ 1

Author(s):

Madhabi Baidya ◽

Mahfuza Shirin ◽

Liton Chandra Saha

Keyword(s):

Perinatal Asphyxia ◽

Care Center ◽

Tertiary Care ◽

Preterm Neonates ◽

P Value ◽

Care Hospital ◽

Cross Sectional ◽

Neonatal Transport ◽

Group I ◽

Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

Download Full-text

Risk Factors Associated with Ischemic Heart Diseases in Different Age Groups Patients of Tertiary Care Hospitals of Peshawar

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.1-2.64 ◽

2015 ◽

Vol 1 (2) ◽

pp. 3-9

Author(s):

Riaz Gul ◽

Sumaira Naz

Keyword(s):

Risk Factors ◽

Heart Diseases ◽

Tertiary Care ◽

Age Groups ◽

Ischemic Heart ◽

P Value ◽

Age Group ◽

Ischemic Heart Diseases ◽

Sedentary Life ◽

Tertiary Care Hospitals

Objectives:To determine different risk factors associated with ischemic heart diseases in different age group patients of tertiary care hospitals of Peshawar.Methodology:A cross sectional study conducted on 350 patients of different age groups presented with ischemic heart diseases in tertiary care hospitals of Peshawar. Study was conducted for duration of 3 months from December 2013 to February 2014. Non probability convenient sampling technique was used. Sample size was calculated using standard sample size calculator. Semi structured questionnaire was used as data collection tool. Patient’s record and investigations were used as adding tools. Standard definition was made for ischemic heart disease. Different modifiable and non-modifiable factors were assessed and were analyzed using SPSS version 16.Results:This study contains 350 patients in which female patients were 133(38%) and male were 217(62%).The mean age was 57.23±11.36 years. The age of the patients ranges from 22 to 80 years. The frequencies of risk factors were stress (73.1%) followed by hypertension (65.7%), sedentary life style (59.4%), family history (57.1%), smoking (50.6%), over weight and obese (39.1%), below normal HDL (30.3%), high LDL (29.1%), hypertriglyceridemia (28%), hypercholesterolemia (23.7%). 64.3% patients were presenting with acute IHD and 35.7% were with chronic IHD. Stress, HTN, DM and sedentary life style were found to be significantly associated with male gender (p- value <0.05). Age was divided into two groups, <45 years and >45 years. Stress, HTN, DM and hypercholesterolemia had a significant association with >45 years of age group. (P-value <0.05).Conclusion:Stress, HTN, DM, sedentary life styles were the major risk factors. And they were found to be more in male gender and in equal to more than 45 years of age group.

Download Full-text

Stunting Diagnostic and Awareness: Impact assessment study of sociodemographic factors of stunting among school-going children of Pakistan (Preprint)

10.2196/preprints.17209 ◽

2019 ◽

Author(s):

Mahvish Ponum ◽

Saadia Khan ◽

Osman Hasan ◽

Muhammad Tahir Mahmood ◽

Asad Abbas ◽

...

Keyword(s):

Rural Areas ◽

Parental Education ◽

Work Capacity ◽

Public Health Issue ◽

P Value ◽

Detailed Knowledge ◽

Age Group ◽

Cross Sectional ◽

Factors Associated ◽

Study Results

BACKGROUND Stunting is a major public health issue in most of developing countries. Although, its worldwide prevalence is decreasing slowly but the number of stunted children is still rising in Pakistan. Stunting is highly associated with several long-term consequences, including higher rate of mortality and morbidity, deficient cognitive growth, school performance, learning capacity, work capacity and work productivity. To prevent stunting, we proposed Stunting Diagnostic and Education app. This app includes detailed knowledge of stunting and it’s all forms, symptoms, causes, video tutorials and guidelines by the Pediatricians and Nutritionists. OBJECTIVE The aim and objective of this study is to assess the prevalence of stunting in school-going children in Multan District of Punjab Pakistan and to analyze the risk factors associated with stunting in children under and over 5 age. This study presents Stunting Diagnostic and Education app to prevent the stunting in children under 5 age and children over 5 age (where required). METHODS A cross-sectional study has been conducted in schools of Multan District, Pakistan for the period of January 2019 to June 2019. Sample data of 1420 children, aged 4 to 18 years using three age groups, were analyzed by using SPSS version 21.0 to assess the prevalence of stunting and to analyze the main factors associated with it. Chi square test was applied in comparison with rural and urban participants and p-value <0.05 was considered as significant. This study includes distribution of sociodemographic characteristics, parental education, working status of mothers, dietary patterns of school going children and prevalence of stunting in school going children. After getting study results, Stunting Diagnostic and Education app was developed according to the instructions of child experts and nutritionists. RESULTS 354 (24.93%) participants were stunted out of 1420, 11.9 % children were obese and 63.17% children were normal. Out of 354 stunted children, higher ratio of stunting was found in the age group of 8-11 years children with 51.98 percentage. 37.85% stunted children were found in the age group of 4-7 years and 10.17% stunting was found in the age group of 12-18 years children. It was observed in the study that male children were highly stunted than female with 57.91 % and 42.09% respectively. Children living in rural areas were more stunted affected as compared to the children living in urban society with percentage 58.76 and 41.24 respectively. CONCLUSIONS Our study concluded that 24.93% children were stunted, out of which, age group of 8-11 years children were highly stunted. The study showed that the literacy of mother or caregiver had high impact on children’s health. Therefore, Stunting Diagnostic and Education app was developed to educate mothers to prevent stunting.

Download Full-text

Metabolic syndrome in alopecia areata: an observational study at a tertiary care center

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20213338 ◽

2021 ◽

Vol 7 (5) ◽

pp. 647

Author(s):

Subrata Kumar Das ◽

Saptadipa Das

Keyword(s):

Metabolic Syndrome ◽

Observational Study ◽

Alopecia Areata ◽

Care Center ◽

Tertiary Care ◽

Age Group ◽

Tertiary Care Center ◽

Cross Sectional ◽

Laboratory Parameters ◽

Number Of Patients

Background: The aim was to evaluate the parameters of metabolic syndrome (MS) in patients of alopecia areata and to investigate the possibility of an existing relationship between MS and alopecia areata (AA).Methods: This cross-sectional observational study included 50 patients with AA who attended OPD of department of dermatology at a tertiary care center during a period of 1 year. Clinical and laboratory parameters were noted in each patient.Results: This study included 50 patients with AA (33 males and 17 females). In the present study maximum number of patients belonged to the age group 20-30 years with 23 patients, followed by 30-40 years with 17 patients. Most of the study subjects, 17 were college students and number of employees were 15. Out of 50 patients 44 had patch(es) and 2 patient had alopecia totalis. In this study out of 50 patients, 38 had mild AA, 7 had AA and 5 patients had severe AA. No significant derangement of clinical and laboratory parameters of MS observed in patients of AA.Conclusions: In the present study we did not observe any significant derangement of clinical and laboratory parameters of MS in patients of alopecia areata.

Download Full-text