[en] Ischemic Heart Diseases (IHD) have the highest cause of mortality in the Islamic Republic of Iran. Unhealthy dietary habits as a major threat make our country prone to an epidemic of non-communicable diseases in the next two decades. The aim of this study was to determine the association of diet, hypertension, hypercholesterolemia and diabetes with risk of developing IHD in Tehran. This case - control study was conducted during 2003 and 2004 in Tehran Heart Center and Tehran Shahid Rajaii Hospital. A sample of 100 IHD patients (cases) and 100 individuals free of cardiovascular symptoms (controls) were entered into the study; the Controls were matched to the IHD patients by age (+- years) and sex. Information was recorded by Food Frequency Questionnaire (FFQ). All data were analyzed with the SPSS for windows, version11. Multivariate analysis showed a significant and positive association between Hypertension, Hypercholesterolemia and Diabetes and risk of developing IHD. Odds ratios for these three risk factors with 95% confidence interval (CI) were: 3.9, 12 and 8.6 respectively. In he cases consumption of high dairy fat and fried foods were significantly high, that increased the risk of IHD 9.8 and 54.6 times, respectively. Also low intake of fish was directly associated with increase of the IHD risk (95% CI, OR: 13.9). Moreover low consumption of vegetables and fruits independently increased the risk of IHD 19.8 times in cases group. Hypertension, hypercholesterolemia and diabetes have a significant association with development of IHD. High consumption of fatty food and low consumption of fish, vegetables and fruits also contribute to development of IHD. (author)

[en] This reports is about valuation method on physiological functionality of food materials. It includes ten reports: maintenance condition of functional foods in Korea by Kim, Byeong Tae, management plan and classification of functional foods by Jung, Myeong Seop, measurement method vitality of functional foods for preventing diabetes, measurement way of aging delayed activation by Lee, Jae Yong, improvement on effectiveness of anti hypertension by functional foods by Park, Jeon Hong, and practice case for the method of test on anti gastritis antiulcer by Lee, Eun Bang.

[en] With the global increase in the diabetic population there is a resurgence of interest in the dual epidemic of diabetes mellitus (DM) and tuberculosis (TB), which have a bidirectional detrimental relationship with negative consequences for co-infected patients. Pakistan is feared to be hit the hardest, occupying fifth position amidst the 22 high burden TB countries, and ranking seventh in the global diabetic burden. The diabetes tuberculosis treatment outcome (DITTO) study was undertaken to determine the impact of diabetes on tuberculosis treatment outcome in Pakistan. The generation of such scientific evidence is useless if it is not utilized for policy making and practice, especially in a developing country like ours with a dearth of resources. In this paper, we have developed a framework for the transfer of scientific evidence regarding the impact of diabetes on TB treatment outcomes into policy and practice. The framework is divided into three components namely; generation of scientific evidence harnessing international and national efforts, informing health policy and practice and addressing other concerns such as social protection, health education and future research. (author)

[en] To evaluate the clinical and radiological characteristics of tuberculous pneumonia (TBPn). We compared the clinical presentation, pneumonia severity index (PSI), and radiological findings of 51 TBPn patients with those of typical pulmonary tuberculosis (PulTB) and community-acquired pneumonia (CAP) patients. The mean age of patients with TBPn was higher than that of patients with CAP or PulTB (66.6 ± 15.8 vs. 53.1 ± 17.1, 54.9 ± 15.7) (p < 0.05). Diabetes mellitus was more common in patients with TB than in those with CAP (24.1% vs. 8.2%) (p < 0.05). The PSI scores for TBPn and CAP were similar (79.5 ± 31.1 vs. 71.8 ± 28.3, respectively) and were higher than that for PulTB (64 ± 26.8) (p < 0.05). The ratio of lower lobe involvement was higher in TBPn and CAP than in PulTB (49% and 75.5% vs. 22.4%, respectively). Cavity formation and centrilobular nodules were more common in TBPn than in CAP (13.7% vs. 6.1% and 74.5% vs. 22.4%, respectively) (p < 0.05). Although TBPn shows a similar clinical presentation to CAP, it is more common in elderly patients and more commonly involves lower lobe involvement with cavity formation and centrilobular nodules. Therefore, in cases in which there may be diagnostic uncertainty, appropriate diagnostic procedures following these findings are required to differentiate these diseases.

[en] Objective: To determine the frequency of acute right ventricular myocardial infarction (RVMI) in patients with acute inferior myocardial infarction. Methodology: This prospective case series study was conducted at Cardiology Department in a period from May to October 2009. A total of 174 patients with acute inferior myocardial infarction were evaluated for the presence of acute right ventricular myocardial infarction (RVMI). Results: Male patients were 135 (77.6%) and females 39 (24.4%). Patient's age ranged from 28 to 82 years with majority in the age group 40 to 60 years. Frequency of RVMI was 27% among patients presenting with acute inferior myocardial infarction. Among patients presenting with acute RVMI, 64 % patients received thrombolysis. Overall 65% patients of RVMI had hospital stay of more than 4 days. Conclusion: Frequency of RVMI among inferior MI patients was 27 % with longer hospital stay. (author)

[en] To determine umbilical artery Doppler velocity parameter systolic: diastolic ratio (S/D ratio) relation with fetal well being and outcome. Setting: Department of Obstetrics and Gynecology, Lady Willingdon Hospital, Lahore Duration of study: Six months from 27-02-2008 to 26-08-2008. Subjects and methods: Sixty patients fulfilling the inclusion criteria were included in this study. They were subdivided into two groups. Group 'A' included 30 normal pregnant women with no medical or obstetrical risk factors and group 'B' included 30 pregnant women having risk factors like, hypertension, diabetes, Rhesus incompatibility, discordant twins, intrauterine growth restriction and non immunehydropsfetalis. Results: In comparison of S/D ratio with risk factors it was observed that S/D ratio < 3 was present in 7 patients (11.6%) with hypertension/preeclampsia, 2 patients (3.3%) with diabetes, 1 patient (1.6%) with intrauterine growth restriction, 9 patients (15.0%) with oligohydramnios, no patient with twin pregnancy while S/D ratio >3 was present in 19 patients (31.6%) in pregnancy with hypertension/preeclampsia, 3 patients (5%) with diabetes mellitus, 11 patients (18.3%) with intrauterine growth restriction, 15 patients (25.0%) with oligohydramnios and only 1 patient (1.6%) with twin pregnancy. It was observed that women with S/D ratio < 3, no neonate was observed with < 4 Apgar at 1 minute. 5 neonates (8.3%) had < 6 Apgar score at five minute, 10 neonates (16.6%) needed resuscitation and 7 neonates (11.6%) were admitted to neonatal unit. On the other hand women with >3 S/D ratio delivered 10 neonates (16.6%) with <4 Apgar score at 1 minute, 23 (38.3%) with <6 score at 5 minutes and 23 neonates (38.3%) needed resuscitation, 21 (35.0%) were admitted to neonatal unit for asphyxia. Conclusion: Umbilical artery Doppler studies is an integral tool while evaluating health of high risk pregnancies. However, it is not appropriate as a screening tool for low risk pregnancies. (author)

[en] Thrombosis accounts for 80% of deaths in patients with diabetes mellitus. Diabetic patients demonstrate tortuous microvessels and larger than normal platelets. Large platelets are associated with increased platelet activation and thrombosis, but the physical effects of large platelets in the microscale processes of thrombus formation are not clear. Therefore, the objective of this study was to determine the physical effects of mean platelet volume (MPV), mean platelet density (MPD) and vessel tortuosity on platelet activation and thrombus formation in tortuous arterioles. A computational model of the transport, shear-induced activation, collision, adhesion and aggregation of individual platelets was used to simulate platelet interactions and thrombus formation in tortuous arterioles. Our results showed that an increase in MPV resulted in a larger number of activated platelets, though MPD and level of tortuosity made little difference on platelet activation. Platelets with normal MPD yielded the lowest amount of mural thrombus. With platelets of normal MPD, the amount of mural thrombus decreased with increasing level of tortuosity but did not have a simple monotonic relationship with MPV. The physical mechanisms associated with MPV, MPD and arteriole tortuosity play important roles in platelet activation and thrombus formation. (paper)

[en] Aim: To find frequency of atrial fibrillation (AF) in patients diagnosed with ischemic stroke. Study design: A Cross sectional descriptive study. Place and duration of study: Department of Medicine, PAF Hospital Mushaf, Sargodha from July 4, 2019 to Jan 4, 2020. Methods: In this study a total of 260 patients were taken after taking informed consent meeting inclusion criteria from Department of Medicine, PAF Hospital Mushaf, Sargodha. The informed consent was taken from patients or attendants. Basic information like, age, gender and contact details were taken of all selected subjects. After basic clinical investigation, ECG was done for all patients with 24 hours of Ischemic stroke who presented to the selected setting. Atrial fibrillation was as per operational definition. On pre designed proforma, data was collected from all patients. Results: The mean age of patients was 57.34±12.82 years with minimum and maximum age as 20 and 80 years. There were 150(57.7%) males. According to operational definition 91 (35%) cases had atrial fibrillation while other 169(65%) cases did not have atrial fibrillation. The frequency of atrial fibrillation was statistically same when stratified for age), gender, smoking, obesity, hypertension, diabetes mellitus. Conclusion: The frequency of atrial fibrillation was seen in 35% of the cases having ischemic stroke. Hence if atrial fibrillation is diagnosed early then ischemic stroke can be prevented. (author)

[en] Objectives: To determine the frequency of silent cardiac ischemia in type II diabetes mellitus patients presenting to tertiary care facility. Methodology: This cross-sectional study was conducted from 20th October 2017 to 20th April 2018 at Department of Medicine Jinnah Hospital Lahore. After a detailed history, measurement of height, blood pressure, weight, fasting blood sugar, body mass index of 237 patients were recorded, and electrocardiography (ECG) was done before and after exercise tolerance testing (ETT). Changes in ECG were assessed and person labeled as having silent cardiac ischemia or not depending on the outcome of the ECG. Results: Mean age was 54.9 ± 5.9 (range: 45 – 63) years. There were 144 male patients and 93 female patients The mean duration of type II diabetes mellitus in the study population was 10.0 ± 2.6 (range: 6 – 15) years. The frequency of silent cardiac ischemia was found to be 45.1%. Increasing age, prolonged duration of diabetes mellitus, history of smoking and hypertension, and increased body mass index were significantly related to silent cardiac ischemia (p-value< 0.05). Conclusion: Silent cardiac is quite prevalent in our population that demands urgent efforts to diagnose this condition earlier for better future outcomes.

[en] Background: Ischemic heart disease is a leading cause of death throughout the world. CAD has been recognized among younger age group more frequently in recent years. Very limited data is available regarding the prevalence of various risk factors in our younger patients that is why this study was planed. Objectives of the study were to look for the risk factors most prevalent in our young patient of first Acute Myocardial Infarction. And to also look for the number of Risk Factors present in each patient. Methods: We studied 100 consecutive patients from 16-45 years of age presenting with first acute MI. Twelve risk factors were studied namely, gender, family history of premature CAD, smoking hypertension, diabetes, dyslipidemia, obesity, mental stress (type A personality), alcohol, oral contraceptive pills (OCPs), physical activity, and diet. We divided the patients into two groups. Group A with patients 35 years of age or less and group B with patients 36-45 years of age. All risk factors were compared in both the groups. Results: Smoking, diabetes mellitus, dyslipidemia and hypertension were statistically different between the two groups. Frequency wise risk factors were lined up as male sex (91%) Diet (66%), Dyslipidemia (62%), smoking (46%), Type A personality(46%), family history (32%), diabetes mellitus (28%), sedentary lifestyle (26%), hypertension (22%), obesity (17%), alcohol (3%), and OCPs (0%) Most of the patients that is 94% had 3 or more risk factors. Conclusion: Smoking, hypertension, diabetes and dyslipidemia are the major modifiable risk factors in our young adults. If a young male who is smoker or a young female who is diabetic, presents in emergency room with chest pain, always suspect coronary artery disease. Other conventional risk factors are also prevalent but alcohol and OCPs are not a major health problem for us. (author)