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Objectives: To determine the prevalence of cerebellar Ataxia in patients with hypothyroidism. Materials and Methods: The design of this study was cross sectional study design and this study was conducted in Shaheed Mohtarma Benazir Bhutto Medical University, Larkana. This study was conducted in the duration of 6 months from July 2022–Dec 2022. Total 13 patients with hypothyroidism were enrolled. Routine blood investigation and Thyroid Function Tests were done for all patients. MRI was done for all patients in order to rule out demyelinating, vascular and structural causes of cerebellar ataxia. All the data was collected in predesigned questioner. Results: A total of 13 patients with mean age of 50.92±11.21 years were enrolled. Out of total, 69.2% patients were male and 30.8% patients were female. Clinical characteristics of enrolled patients are given in table 1-0. The mean and SD value of T3, T4 and TSH were 50.9±11.21, 2.80±0.63 and 77.30±10.57 respectively. The TPO antibodies test were performed that shows mean value of 31.15±3.38, that fall in normal range. And MRI brain was also normal. Distribution of patients on the basis of Ataxia was done and it was found that 4 (30.8%) had ataxia. Practical implication: This study will help the clinical practitioner to keep in mind that there is chance of ataxia in patients suffering from hypothyroidism. So the clinical practitioner should take care of the patients to avoid such complication. There is evidence that the ataxia has been reversed by thyroid replacement therapy. Conclusion: It is concluded that Hypothyroidism is responsible to cause cerebellar ataxia. Therefore early treatment should be taken to avoid this manifestation. Keywords: Cerebellar Ataxia, hypothyroidism, Thyroid Function Tests

Objectives: To determine the effect of IV iron therapy on patients with Iron deficiency presenting with somatic symptoms. Materials and Methods: The design of this study was The Quasi-experimental study design and this study was conducted in Shaheed Mohtarma Benazir Bhutto Medical University, Larkana. This study was conducted in the duration of 6 months from July 2022–Dec 2022. Totally 90 patients were enrolled. 5ml venous blood sample were collected from of each patient and sent to laboratory of the hospital for complete blood count and serum ferritin level. Patients with iron deficiency were treated with IV iron. Then after eight-week treatment the patients were followed again and 5ml blood were collected in EDTA containing tube. Serum ferritin level was evaluated again at the end of 8 weeks. Somatic scoring scale was used to assess somatic symptom burden before and after IV iron therapy. Results: Out of 90 patients, 40.0% were male and 60.0% were female with mean age of 39.70± 7.30 years. Most of the patients were of age group 41-50 years, followed by the age group of 31-40 years and least number of patients were of age group of 20-30 years. The mean difference of somatic score of our enrolled patients were 7.01±0.33 with P-value of

Background: Liver has a special and unique system of glucose metabolism which keeps its levels under normal ranges. In chronic liver hepatitis and cirrhosis this mechanism is altered. Aim: To evaluate undiagnosed diabetics through HbA1C and 2 hours post prandial blood sugar levels in confirmed hepatitis B and C cirrhotic adult patients. Study design: Descriptive cross-sectional study Place and duration of study: Department of Gastroenterology, Chandka Medical College, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana from 1st July 2020 to 30th June 2021. Methodology: One hundred and twenty four patients >50 years with liver cirrhosis due to hepatitis B and C were enrolled. All clinical, demographic data of patients as well as their blood analysis was performed for testing HbA1C and two hour post prandial blood sugar (as well as liver function test). Results: The mean age was 57.9±5.9 years and majority of patients were males in both hepatitis cases. There were 39.5% of liver cirrhosis patients having undiagnosed diabetes which was confirmed by 2 hours post prandial blood sugar and HbA1c. Within this value 54.8% had hepatitis C and 24.2% had hepatitis B. Conclusion: There is a high prevalence of elevated HbA1c, post prandial blood sugar and consequently diabetic population (undiagnosed) among hepatitis B and C liver cirrhotic adult patients. Keywords: Post-prandial blood sugar, Cirrhotic adult patients, HBsAg, Anti-HCV, Diabetics

Background: In chronic hepatitis diseases the liver impairment results in imbalance in glucose homeostasis and metabolism resulting in type 2 diabetes Aim: To estimate the frequency of type 2 diabetes in chronic hepatitis B and C patients. Study Design: Cross sectional analytical study Place and Duration of Study: Department of Medicine, Chandka Medical College Hospital, Larkana 1st October 2020 to 31st March 2021. Methodology: One hundred patients of hepatitis were recruited. Fifty patients of hepatitis B and 50 patients of hepatitis C age 20-65 years were enrolled. Their fasting blood sugar and HbA1C levels were analyzed and correlated with their clinical symptoms. Results: 20% hepatitis B and 26% hepatitis patients had asymptomatic type 2 diabetes. There were more men affected from hepatitis than women and type 2 diabetic respectively. Conclusion: Asymptomatic type 2 diabetics need suffering from hepatitis B and hepatitis C need to be screened for better treatment plan. Keyword: Hepatitis B, Hepatitis C, Type 2 diabetes

Aim: To determine knowledge of hypoglycaemic symptoms & their self-management among pts with type II diabetes mellitus. Study Design: Descriptive, cross-sectional. Place and duration of study: OPD Clinic of Department of Medicine, Chandka Medical College Hospital Larkana from 23rd May 2019 to 22nd November 2019. Methodology: One hundred and thirty five patients with type II diabetes mellitus of age 35- 60 years were selected. Patients with type I DM and neuro-psychiatric illness were excluded. The symptoms of hypoglycemia and their responses to those symptoms were recorded. Results: The mean age of 47.07±6.04years and majority of the patients 83 (61.48%) were between 46-60 years of age. Seventy two (53.33%) were male and 63 (46.67%) were females. Mean duration of diabetes mellitus was 6.90±3.86 years. Adequate knowledge of hypoglycemic symptoms and their self-management among patients with type II diabetes mellitus was found in 62 (56.9%) patients. Conclusion: Hypoglycemic patients are significantly unaware of their condition and have a very low knowledge about hypoglycemia and its self-management. Keywords: Type II diabetes, Hypoglycemic symptoms, Knowledge