iosr-JDMS   Volume-8 ~ Issue-2

Abstract:Objective: To access diagnostic usefulness of Gene Xpert MTB/RIF assay technique in management of tuberculosis. Study Design: Observational Study. Setting: Pathology (Microbiology) Department Sheikh Zayad Medical College/Hospital Rahim Yar Khan Period: November2012 to Febrauary2013. Materials and Methods: 224 Sputum samples from pulmonology department. All samples were tested on Gene Xpert for MTB/RIF detection after AFB microscopy. Results: Chi-Square test applied; P value is <0.001. all results are highly significant. Conclusion: (I) Gene Xpert is more specific and sensitive technique. (II) It helps to avoid injudicious use of anti tuberculosis drug.

Key words; AFB, Gene Xpert, MTB/RIF, TB and ZN staining .

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[6]. Centers for Disease Control and Prevention. Biosafety in microbiological and biomedicallaboratories. Richmond JY and McKinney RW (eds) (1993). HHS Publication number(CDC) 93-8395.

Abstract: This is a report of a 50 year old lady with quadriparasis who was extensively evaluated before presenting to us with imaging and nerve conduction study and diagnosed as sensory motor predominantly axonal polyneuropathy of unexplained etiology. When we evaluate the patient and a chest X-ray and further work up revealed a surprise finding.

Keywords: Polyneuropathy, paraneoplastic syndrome, Small cell lung cancer

[1]. Massimo Camerlingo, MD; Raffaello Nemni. Malignancy and Sensory Neuropathy of Unexplained Cause. Arch Neurol. 1998;55(7):981-984.
[2]. Thankappan KR & Thresia CU.Tobacco use & social status in Kerala.Indian J Med Res 2007;126:300-308
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[4]. Oppenhein H: Uber Hirnsymptome bei Carcinomatose ohne nachweisbare veranderungen im Gehirn.Charite-Annalen (Berlin) 1888;13:335-344
[5]. Richardson GE, Johnson BE (1992) Paraneoplastic syndromes in lung cancer. Curr Opin Oncol 4, 323-333.
[6]. Seute T, Leffers P, ten Velde GPM, Twijnstra A (2004) Neurologic disorders in consecutive patients with small cell lung carcinoma. Cancer 100, 801-806. [7]. Rosenfeld MR, Dalmau J (2003) Current therapies for paraneoplastic neurologic syndromes. Curr Treat Options Neurol 5, 69-77.

Abstract:AIMS AND OBJECTIVES- This study was undertaken to evaluate the extent of cardiac dysfunction by echocardiography assessment and TMT performance in patients of NIDDM with normal resting ECG. Methodology- Fifty type-II diabetic patients were evaluated with normal resting ECG irrespective of age and sex admitted in the wards of Department of Medicine was selected for the study. The diagnosis of diabetes was made according to WHO criteria -Symptoms of diabetes plus random blood glucose concentration  11.1 mmol/L (200 mg/dl).Or Fasting plasma glucose  7.0 mmol/L (126 mg/dl).Or Two hour plasma glucose  11.1 mmol/L (200 mg/dl) during an oral glucose tolerance test. All subjects were subjected to routine and special investigations which included 12 lead ECG, TMT, and echocardiographic assessment. Results: Out of the 50 patients, 33 patients (66%) had abnormal echocardiographic findings. 50% of the patients (25 out of 50 patients.) had diastolic dysfunction while 34% (17 out of 50 patients) had left ventricular hypertrophy. Diastolic dysfunction was highest in patients >60 years of age (90.91%) compared to 47.8% and 25% in the age group 46-60 years and 30-45 years respectively. The incidence of diastolic dysfunction was the highest (100%) in patients with diabetes duration >10 years. 40% of the patients had HbA1C level >10% of which 65% had diastolic dysfunction. TMT was positive in 05 out of 50 patients (10%). Out of the 17 females, two (11.76%) had positive TMT compared to three (9.09%) positive TMT out of 33 males. Conclusion: The results of this study suggest that the incidence of left ventricular diastolic dysfunction is higher in NIDDM patients who are free of clinically detectable heart disease. It was found that the incidence of diastolic dysfunction had a strong correlation with the age , duration of diabetes, HbA1C level and diabetic complications. Stress test positivity in type-2 diabetic patients didn't show any correlation with sex, age, addiction, duration of diabetes, and systolic blood pressure. In the present study, it was also found that asymptomatic coronary heart disease occurs in type 2 diabetic patients. Hence it is advisable to screen these patients by TMT and confirm/rule out coronary heart disease by coronary angiography.