[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] 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] 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] 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] 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)

[en] Objective: To evaluate the in-hospital mortality of acute myocardial infarction among different age groups. Subjects and Methods: The subjects were 460 admitted patients of acute myocardial infarction who fulfilled our inclusion criteria. Patients were divided into four age groups. Group-I included patients in 20-40 years, group-II (41-50 years), group-III (51-60 years) and group-IV (>60 years). Mortality was compared between different age groups by Chi-square and linear-regression models. Results: The total in-hospital mortality was 16.7%. It gradually increased from 5.6% in group-I (20-40 years) patients to 21% in group-IV (>60 years) patients. While mortality in groups group-II (41-50 years) and group-III (51-60 years) patients was 16.7% and 18.6% respectively. A marked increase in mortality was noted with increase in age. Group- IV (>60 years) patients presented 2 hours late to the hospital than the group-I (20-40 years) patients. There was no statistical difference in site of infarction in different age groups. Old age (group-IV i.e. >60 years old) was more associated with heart failure (higher Killip class) on presentation. Lesser number of patients in group-IV received thrombolytic therapy than group-I. Only 31.09% patients in group-IV and 62.5% patients in group-I received streptokinase therapy respectively. Conclusion: In patients with acute myocardial infarction age was a powerful independent predictor of in-hospital mortality and complications. (author)

[en] Mucormycosis is a highly invasive, devastating and usually fatal fungal infection of the sinuses, brain, or lungs that occurs primarily in people with immune disorders. Despite advances in diagnosis and treatment, a high mortality still exists. We present a middle aged diabetic male with this serious fungal infection involving nose, paranasal area and adjacent periorbital regions with a high risk of progressing further towards the dura mater. He was promptly diagnosed and managed with serial surgical debridements with systemic antifungals and was later fitted with a nasal prosthesis. (author)

[en] Background: Diabetes, Hypertension, Obesity and Ischaemic Heart Disease have become a problem of public health magnitude with substantial economic burden both in the developed as well as the developing countries. Obesity is quite frequent in Type 2 diabetics and also plays a central role in causing Metabolic Syndrome (MetS). Metabolic Syndrome significantly increases the incidence of cardiovascular complications. This study was done to determine the frequency of MetS in our Type 2 diabetic patients as most of the components of MetS can be modified and identifying/managing these at an early stage might be of considerable help in reducing cardiovascular complications. Methods: This cross-sectional study was done in Medical B and Medical A wards of Ayub Teaching Hospital, Abbottabad from Nov, 08 to April, 09. Type 2 Diabetic patients aged above 40 years who gave informed consent were included in the study. Data was collected through a structured proforma. Frequency of Metabolic Syndrome was estimated according to the IDF consensus worldwide definition of the MetS. Results: Of the 100 patients enrolled in this study 56 were females and 44 were males with a mean age of 59.9 years. Out of these 100 participants seventy six (76%) were diagnosed to have metabolic syndrome. Of the 56 females, forty eight (85.71%) were having metabolic syndrome while twenty eight (63.63%) of the 44 male participants were having the syndrome. The difference was statistically significant (p<0.05). Conclusion: Frequency of MetS was found to be significantly high in this study with female preponderance. All the components, except Hypertension were more frequent in females. Diabetic patients with metabolic syndrome need more aggressive approach in management so as to decrease the incidence of cardiovascular complications. (author)