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OBJECTIVE: To evaluate the frequency of allergic rhinitis in patients with bronchial asthma and to identify risk factors for this association. STUDY DESIGN: A cross sectional observational study. PLACE & DURATION: At Liaquat University of Medical & Health Sciences Jamshoro/Hyderabad, from 1st Aug, 2014 to 31st Dec, 2015. METHODOLOGY: A total of 100 patients with cough, dyspnea and chest pain were examined and out of those, 87 patients having bronchial asthma, as per clinical evaluation based on global initiative for asthma guidelines (GINA) were selected for the study and then those having allergic rhinitis, based on allergic rhinitis and its impact on asthma guidelines (ARIA) were identified using clinical and pathological parameters (Eosinophilic count on nasal smear). RESULTS: Among a total of 87 patients of bronchial asthma, 43.68% were males and 56.32% females. Out of those, 64.37% were having allergic rhinitis. The most common variety of bronchial asthma was intermittent and the most common variety of allergic rhinitis was moderate to severe persistent. We found smoking, urban residence, traffic pollution, overcrowding, small ill ventilated rooms, use of carpets in rooms and use of wood for cooking and heating purposes as the risk factors for this association. Out of 56 patients of AR, 73.2% were smokers and smoking was more common in females (53.65%). CONCLUSION: The frequency of allergic rhinitis is fairly high in patients with bronchial asthma. Urban residence, traffic pollution, overcrowding, small ill ventilated rooms and smoking were found responsible for this high prevalence. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate patient's satisfaction of endoscopy at Tertiary Care Hospital. STUDY DESIGN: A cross sectional observational study. PLACE AND DURATION: This study was conducted at Medical unit IV, Liaquat University of Medical & Health Sciences (LUMHS) Jamshoro from 27th Aug'2015 to 26th Feb'2016. Methodology: Our study population included 126 patients who underwent endoscopy. Patient satisfaction after the endoscopy was assessed by modified Group Health Association of America-9 (GHAA-9) questionnaire. In terms of satisfaction, patients were asked to rate the waiting time at the office, the personal manner and technical skills of physician, the personal manner of support staff, adequacy of explanation about the procedure and overall rating of the visit. They were also asked to rate how long they waited to get an appointment. RESULTS: The average age of patients was 40.94±10.77 years. There were 57.94% males and 42.06% females. A high percentage of patients' voiced satisfaction of the endoscopic procedure (87.3%). Satisfaction rate for waiting time for appointment and on the procedure day was lower compared to other questions. Stratification analysis showed that satisfaction rate was not significant among different age groups (p=0.146). Similarly satisfaction of endoscopy was also above 80% in both males and females which is also not significant (p=0.34). CONCLUSION: Although a high proportion of patients were satisfied with endoscopy, we identified discomfort during procedure and long waiting time as the main factors for patient dissatisfaction. To further increase patient satisfaction, it is imperative to address these factors. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate with endoscopy the common causes of upper gastrointestinal bleeding in patients presenting with hematemesis within 24 hours of admission. DESIGN: A cross sectional observational study. SETTING: Medical unit III, LUMHS Jamshoro. DURATION: Six months from 1st Jul, 2014 - 31st Dec, 2014. METHODS: One hundred cases of hematemesis were included in the study. Patients who refused endoscopy and those on NSAIDs, anticoagulants & steroids were excluded from study. Upper gastrointestinal endoscopy was performed within 24 hours of admission. RESULTS: Out of 100 patients selected, 51 (51%) were males and 49 (49%) females. Majority of patients were between 30-60 years with mean age of 43.97 years ±SD 7.8. Variceal bleed was the most common cause n=54 (54%) followed by peptic ulcer disease (PUD) n=20 (20%). Esophagitis was noted in ten (10%) patients, gastric erosions in nine (9%), tumors of upper gastrointestinal tract in six (6%) and Mallory-Weiss tear was responsible in only one (1%) cases. CONCLUSION: Variceal bleeding secondary to portal hypertension is the most frequent cause of bleeding in upper gastrointestinal tract. Increased prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) in this part of the world has resulted in increased incidence of liver cirrhosis and portal hypertension highlighting the importance of prevention of HBV and HCV. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate patients of non-variceal upper gastrointestinal bleeding for clinical intervention on the basis of Blatchford scoring system. STUDY DESIGN: A cross sectional observational study. PLACE AND DURATION: At Medical Unit III, Liaquat University of Medical & Health Sciences (LUMHS), Jamshoro from 1st Sep'2014 - 28th Feb '2015. METHODOLOGY: Study population included 50 patients of upper gastrointestinal bleeding. Blatchford score was calculated for each patient. Patients needing clinical intervention to control bleeding were defined as high risk having a Blatchford score of =5. RESULTS: A total of 50 patients took part in this study with a male to female ratio of 1.5:1. The age range was 20-85 years, with mean age of 39.24 ± 13.37 years (SD). The Blatchford score identified 20 of 50 patients as high risk for clinical intervention. These patients presented with 2-3 episodes of hemetemesis and vitally un- stable and referred for endoscopy. Two third of our patients presented with one episode of bleeding and vitally stable & were categorized as low risk. Peptic ulcer disease came out to be the main cause of non variceal bleeding on endoscopy. CONCLUSION: Decision for endoscopy depends upon Blatchford score and general health of patients. We observed Blatchford score to be helpful for differentiating among high and low risk groups and to evaluate the need for clinical intervention in patients of upper gastrointestinal bleeding admitted in the hospital. [ABSTRACT FROM AUTHOR]

The crucial apprehension of high level of performance in sports is the final performance whether it is during training or sports competition. The ultimate result relies on intricacy of factors. Level of performance can be improved if the physical educationist and coaches more inclusively understand the anatomy and working of skeletal muscles. It can be examined by reviewing the size; shape and form of athlete's body and for this rationale, a series of preferred anthropometric dimensions and physiological parameters of athletes are measured. The affiliation among any two parameters can play a helpful role in performance. Several aspects are responsible for the performance of badminton players. Basic skills of badminton such as various types of serves, loops and lobs, smashing and blocking, involves a particular type of physique having specific proportions with specified provisional capabilities, observed in physiological variables for instance vital capacities, heart rate, blood pressure and breathing frequency at rest. The aim of this study is to evaluate the measurements and proportions of the human body (anthropometry) and physiological diversities in various degrees performance among male badminton players belonging to District Hyderabad Sindh. Every now and then Physical Educators and trainers are involved with team assortment plus the coaching and scientific training of athletes for competitions. Their job requires a relevant understanding of the sport concerned and in addition to the techniques and strategy concerning that game and an insight of the anthropometrical and physiological differences which materialize the basis of good techniques and tactics. The study will be of significance in tendering awareness in the domain of Badminton. For present study National and all Pakistan Intervarsity level players were considered as High level competitors while District, Region and Collegiate level Players were considered as Low level competitors A total of 20 subjects (10 from each category that is high & low level Badminton competitors) were selected randomly. Anthropometrical measures, body Indices and physiological considerations such as blood pressure, vital capacity, heart rate and resting breathing frequency were measured to evaluate the study variables. Present research observed that top level badminton competitors were greater than bottom level badminton competitors in mass, forearm, leg and foot length, biceps and calf muscle girth, vital capacity and mesomorphy whereas bottom level badminton competitors were bigger in lengthwise measurement of hand, shoulder girth, hip girth, biceps skin fold, heart rate, diastolic and systolic blood pressure, breathing frequency at rest, sitting height - height index, thigh, lower and upper leg length indices, upper and lower arm length indices, hip width - stature, shoulder width - statue and hand length-wrist width indices, whereas in rest of the variables, the differences were insignificant. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate different clinical presentations of chronic kidney disease (CKD) and to raise the index of clinical suspicion so to diagnose and treat CKD at the earliest. STUDY DESIGN: A cross sectional observational study. PLACE AND DURATION: Medical unit III, Liaquat University hospital, Jamshoro from 1st Apr - 30th Sep'2014. METHODOLOGY: We studied fifty patients of CKD, diagnosed by standard clinical criteria. A self administered questionnaire was used to record patient's history and clinical examination. Complete blood count, urine analysis, urea, creatinine, electrolytes, sugar, calcium, spot urine albumin to creatinine ratio and renal ultrasound were done in every patient. In selected cases, renal biopsy was also done. RESULTS: Out of 50 patients, 62% (n = 31) were men, a mean age of 46.22 years (± 12.89 SD), a mean creatinine clearance of 5 mmol/24 hours (±2.16 SD), a mean albumin: creatinine ratio of 49 mg/g (±11.33 SD) and a mean serum creatinine of 16.5 mg/dl (±6.65 SD). Chronic glomerulonephritis (30%), hypertension (24%) and diabetic nephropathy (20%) were the leading causes of CKD. Anemia (94%) was universal finding on laboratory work up. Gastrointestinal manifestations stand out among the clinical presentations with anorexia (76%), nausea (60%) vomiting (40%) and abdominal pain (26%). CONCLUSION: We observed that gastrointestinal disturbances are the commonest clinical presentations in CKD along with anemia, fatigue, dyspnea, hiccups, itching, hypertension and edema. Early diagnosis and management of CKD may prevent or delay the progress to end stage renal disease. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the knowledge, attitude, prevalence and factors leading to smoking among students at the Center for Physical Education and Sports Science, University of Sindh, Jamsoro Pakistan. A total of 148 (128 males and 20 females) students of Center for Physical Education and Sports Science were randomly selected. A self-administered questionnaire was used to elicit information on demographics, smoking habits, attitude towards public action against smoking and knowledge of health hazards. Smoking was more common among bachelors (n=18) than master's degree students (n=04). There were 22 smokers, but most of them were occasional smokers (n=13). All female students indicated that they never smoked. The students' ages ranged from 18-35 years (mean age 22. 3 ± 9.37 years). Sixteen students started smoking between ages 10-20 years. Out of 22 smokers, only five were heavy smokers (>20 cigarettes/d). The most favoured smoking tool was filter tipped cigarettes (n=12). The most common reason for smoking was peer pressure (n=12). Majority of students (n=53) who do not smoke believed that it is a useless habit. Twelve smokers and 112 non-smokers favoured banning smoking advertisements in print and electronic media. Fourteen smokers and all non-smokers favored banning smoking at public places. Both smokers (91%) and non smokers (98%) had good knowledge of health hazards associated with smoking and passive smoking. Smoking still constitutes a major problem among university students inspite of their knowledge of its hazards. This may be due to the addictive effect of smoking, peer pressure, negative parental attitudes and other reasons. There is a need to implement an anti-smoking programme for college students in order to educate them on the health implications of smoking, thereby possibly preventing or controlling smoking among the students. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To assess different patterns of retinopathy in diabetic patients admitted at LUMHS & to determine risk factors for diabetic retinopathy (DR). METHODOLOGY: This descriptive (case series) comparative study was conducted in medical unit IV, LUMHS Jamshoro/ Hyderabad from January 2009 to June 2009. Total 100 patients either known cases or newly diagnosed cases of both type1 and type2 diabetes mellitus, aged 20 to 60 years, were selected. All patients were subjected to thorough history taking & clinical examination. Blood pressure, weight & body mass index (BMI) were recorded & systemic examination done. Every patient then underwent a detailed ophthalmoscopic examination by the principal researcher. Blood & urine samples of those having DR were taken for HbA1c estimation, hemoglobin levels & proteinuria. RESULTS: Out of 100 diabetic patients examined, 24 (24%) had diabetic retinopathy (DR). The commonest form of DR was non-proliferative (74.9% [mild: 33.3 %, moderate: 29.1 %, and severe: 12.5 %]), followed by Maculopathy (16.6 %) and proliferative diabetic retinopathy (8.3 %). The frequency of DR was higher among individuals with type 1 diabetes, having early onset and greater duration of diabetes with proteinuria, poor glycemic control with high blood pressure & among women, anemic & obese patients. CONCLUSION: Routine retinal screening for Diabetic retinopathy at the time of diagnosis in type2 diabetes and annual retinal screening in both type1 and type2 diabetes can considerably reduce the risk of visual loss. [ABSTRACT FROM AUTHOR]

Objective: To observe frequency of various causes of stroke in patients of young (15-35 years) age., Methods: This Descriptive case series study was conducted in all Medical Units of Liaquat University Hospital (LUH) Jamshoro, Hyderabad, from August 2006 to February 2008 and included 50 patients of stroke aged 15-35 years, irrespective of sex and community. Data of these patients was collected through a pre-designed proforma by completing a comprehensive history, detailed examination and carrying out basic and relevant investigations. Patients suffering from hypoglycaemia, space occupying lesions, transient ischaemic attack or psychosis were excluded from the study. The collected data was analyzed on SPSS version 16.0., Results: Out of total number of 113 acute strokes, 50 patients fulfilling inclusion criteria were selected, comprising 30 males and 20 females. Forty-three (86%) patients suffered from ischaemic strokes while seven (14%) had haemorrhagic strokes. Infective meningitis including Tuberculosis meningitis and Bacterial meningitis was the leading cause of stroke (34%). The second most common cause was cardio-embolism (20%) comprising Valvular heart diseases (14%), Cardiomyopathies (4%) and atrial myxoma (2%).Hypertension was found in 14% cases. Pregnancy related causes (including Pregnancy induced hypertension and puerperal sepsis) were 12%. Systemic lupus erythematous and nephritic syndrome was 4% each. Various causes which constitute 4% or less were grouped together as miscellaneous and they include hyperhomocysteinaemia, and hyperlipidaemias., Conclusions: Common cause of stroke detected was infective meningitis (Tuberculosis and Bacterial). Predominant cause of haemorrhagic stroke was Hypertension. Stroke in young age occurred predominantly in males. Cardio embolism, pregnancyinduced hypertension and puerperal sepsis were other major causes.