Chandka Medical College

About: Chandka Medical College is a education organization based out in Larkana, Pakistan. It is known for research contribution in the topics: Medicine & Population. The organization has 106 authors who have published 108 publications receiving 1170 citations.

Use of dark chocolate for diabetic patients: a review of the literature and current evidence

Abstract: Dietary changes are a major lifestyle factor that can influence the progression of chronic diseases such as diabetes. Recently, flavanols, a subgroup of plant-derived phytochemicals called flavonoids, have gained increasing attention, due to studies showing an inverse correlation between dietary intake of flavanols and incidence of diabetes. Flavanoids in the cocoa plant may ameliorate insulin resistance by improving endothelial function, altering glucose metabolism, and reducing oxidative stress. Oxidative stress has been proposed as the main culprit for insulin resistance. The well-established effects of cocoa on endothelial function also points to a possible effect on insulin sensitivity. The relationship between insulin resistance and endothelial function is a reciprocal one. Overall, the evidence from these studies suggests that cocoa may be useful in slowing the progression to type 2 diabetes and ameliorating insulin resistance in metabolic syndrome. Additionally, results from several small studies indicate that cocoa may also have therapeutic potential in preventing cardiovascular complications in diabetic patients. Studies highlighting the potential of cocoa-containing diets, in large-randomized controlled trials should be performed which might give us a better opportunity to analyze the potential health-care benefit for reducing the risk of complications in diabetic patients at molecular level.

Frequency and predictors of depression in congestive heart failure.

Abstract: Background Depression in congestive heart failure (CHF) patients can increase morbidity and mortality. Given the ever-rising prevalence of CHF patients with depression, it is vital that we understand the predictors of depression in these patients to identify and better manage these patients. The main objective of this study was to evaluate the frequency and predictors of depression in CHF patients. Methods A cross-sectional study was conducted in a tertiary care hospital. Patients with a diagnosis of CHF for more than 6 months based on signs and left ventricular ejection fraction Results Of 170 participants, 102 (60%) had depression. Among these 102 patients, 42% (n = 43) had mild depression, and the rest (n = 59) had moderate-to-severe depression. Predictors of depression were New York Heart Association stage 3 or 4 (p = 0.001), previous myocardial infarction (p = 0.001), living without a partner (p = 0.001), lack of a joint family system (p = 0.001), sedentary lifestyle (p = 0.001), aged 70 years or more (p = 0.01), and having been admitted in a hospital at least once in the past two months (p = 0.002). Conclusion Depression is common among patients with CHF. It is associated with multiple factors and needs to be addressed and targeted urgently.

Lumbar disc prolapse: management and outcome analysis of 96 surgically treated patients.

Abstract: OBJECTIVE To evaluate the presentation, diagnosis and management outcome of surgically treated patients of lumbar disc prolapse. DESIGN This is a prospective study. SETTING AND DURATION OF STUDY: The study was conducted at Department of Neurosurgery, Chandka Medical College Hospital, Larkana over a period of three years. SUBJECT AND METHODS Patients were selected using following neuroimagings like plain radiographs, myelograms, CT myelograms and MRI Scan of lumbosacral spine. The operative procedure applied was hemilaminectomy and removal of herniated disc material. Postoperatively patients were analyzed for outcome by standard subjective analysis (Mac nab criteria), objective examinations and radiographic studies. RESULTS There were 96 patients, 70 males and 26 females. Predominant mode of presentation was low back pain with radiation to leg (46.9%), neurogenic claudication in 18 patients (18.7%). Eighty Six percent of the disc prolapses were found at L4 L5 and L5 SI levels. Complication rate was 14.6% with infections being commonest. Excellent to good outcome was found in 85.4% of the cases. Mean follow up period was 18 months. CONCLUSION Surgery for cauda equina syndrome and motor deficits has a good outcome with hemilaminectomy and is the best surgical option for large disc prolapses.

Frequency of Obstructed Labor in Teenage Pregnancy

Abstract: Aims: Teenage pregnancy has globally recognized as high risk pregnancy. Under grown pelvic bones at delivery pose greater risk of obstructed labour in such young girls resulting in poor feto-maternal outcome. Objective of this study was to determine the frequency of obstructed labor in teenage pregnancy and to know fetomaternal outcome. Methods: This Cross Sectional Observational study was conducted at department of Obstetrics and Gynecology unit I and II, Shaikh Zyed Women Hospital Chandka Medical College, Shaheed Mohtarma Benazir Bhutto Medical University Larkana Sindh Pakistan from 1st January 2010 to 31st December 2010. 468 women admitted with obstructed labour of all age groups, out of these which 257 patients were teenage mothers. Patients selected after fulfilling selection criteria. Obstructed labour in teenage patients wasdiagnosed on the basis of history of prolonged labour and clinical presentation. Demographical characteristics noted. Mode of the delivery and fetomaternal outcome was observed. Statistical analysis was performed using SPSS. 12 version. Results: Total deliveries in both units during study period were 9000. Among them 468(5.2%) patients found to have obstructed labour. Out of these 257(2.85% of total) patients were teenagers.. 82% (210) teengers were non booked and admitted in emergency while only 18 %(47) came through OPD having a single visit. Mean age was 16±2 years and parity was 2±1.5.Mode of delivery was LSCS in 84% (214) ,assisted vaginal delivery in 12% (32) and 4% (11)had spontaneous delivery with episiotomy. Cephalopelvic disproportion remained the commonest reason of obstruction (66%). 1.94% (5) of patients died of septicemia .PPH seen in 41% (105),1.1% (3) had scar dehiscence due to prolonged trial by untrained birth attendant.1.94% (5) patients developed vesicovaginal fistula later on. Perinatal mortality was around 54.6% (142) while 44.75 % (115) babies born alive. Conclusions: Adolescent pregnant women not only face pregnancy related problem but also they are prone to have obstructed labour due to their developing pelvic bones. Obstructed labour is one of the most common and preventable causes of maternal and perinatal deaths and disabilities. Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 1 / Issue 13 / Jan- June, 2012 / 37-40 DOI: http://dx.doi.org/10.3126/njog.v7i1.8834

Zoophilic feeding behaviour of phlebotomine sand flies in the endemic areas of cutaneous leishmaniasis of Sindh Province, Pakistan.

Abstract: Leishmania (Leishmania) major has been identified as the major causative agent of cutaneous leishmaniasis in Sindh Province of southern Pakistan. To make a rational approach for understanding the pathogen transmission cycles, the sand fly species and their natural blood meals in the endemic areas were examined. Total DNA was individually extracted from sand flies collected in four villages in Sindh Province. PCR–RFLP (restriction fragment length polymorphism) and sequence analysis of the 18S ribosomal RNA gene revealed that female sand flies identified were Sergentomyia clydei/Sergentomyia ghesquierei/Sergentomyia magna (68.6%), Sergentomyia dubia (17.1%), Phlebotomus papatasi (7.4%), Phlebotomus alexandri-like sand flies (3.4%) and Sergentomyia dentata (3.4%). PCR amplification of leishmanial kinetoplast DNA did not result in positive signals, suggesting that all 175 tested female sand flies were not infected with leishmanial parasites or contained undetectable levels of leishmanial DNA. Amplification and sequencing of the vertebrate cytochrome b gene in 28 blood-fed sand flies revealed that P. papatasi fed on cattle and wild rat whereas P. alexandri-like specimens fed on human, cattle, goat and dog. Although Sergentomyia sand flies are generally known to feed on cold-blooded animals, S. clydei, S. dubia and S. ghesquierei preferred humans, cattle, goat, sheep, buffalo, dog, donkey, wild rat and Indian gerbil. The epidemiological significance of the zoophilic feeding on various host species by Phlebotomus and Sergentomyia sand flies in Pakistan is further required to study for better understanding the zoonotic transmission of sand-fly-borne pathogens and for appropriate management of the vectors.