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Biomedical subjects

M Azfar

Publications and source records attributed to M Azfar.

6 recordsLinked to original sources

Prevalence of chronic complications and associated factors in type 2 diabetes.

OBJECTIVE: To determine the prevalence of chronic complications and associated factors in type 2 diabetes in 500 diabetic patients, age > or = 25 years, attending the clinic of Diabetic Association of Pakistan (DAP), Karachi. METHODS: Every 5th registered diabetic patient > or = 25 years age, was examined for the presence/absence of micro and macro vascular complications and associated factors. Blood samples were collected for HbA1c, lipid profile and serum creatinine. Urine was examined for albumin and microalbumin. RESULTS: Of the 500 diabetic patients examined (160 males, 340 females, mean age 55.2 10.6 years), retinopathy was seen in 43%, neuropathy in 39.6% and foot ulcers in 4%. Nephropathy was found in 20.2%, and was significantly associated with hypertension. The prevalence of microvascular complications was higher in the group of patients with HbA1c > 8% and was significantly related to duration of diabetes, hypertension and obesity. Hypertension was manifest in 64.6% patients, 61% had raised Body Mass Index and Waist Hip Ratio was more than normal in 88% subjects. Macrovascular complications were encountered in 102 diabetic patients, with angina in 85 (17%), heart attack in 25 (5%) and stroke in 13 (2.6%). CONCLUSION: The prevalence of diabetic microvascular complications was higher in people with poor glycaemic control, longer duration of diabetes and associated hypertension and obesity.

Adult↗

Internal pancreatic fistulae with serous effusions in chronic pancreatitis.

BACKGROUND: Serous effusions in chronic pancreatitis are infrequent but persistent. These occur usually as a consequence of internal pancreatic fistulae and commonly involve the pleural cavity or peritoneum. METHODS: To assess strategies in operative management, the records of 12 patients who underwent surgery for internal pancreatic fistula with underlying chronic pancreatitis were reviewed retrospectively. Seven patients had pancreatic ductal calculi. Three cases underwent external drainage. Three cases with leaking pseudocysts underwent cystojejunostomy-en-Y. Three cases with ductal dilatation or calculi underwent lateral pancreaticojejunostomy and three patients had caudal pancreatectomy for distal disease. RESULTS: Eight patients were completely controlled of all symptoms, with no sequelae. One case each had recurrent pancreatitis and ascites but did not require re-operation. There were two deaths: one with massive haematemesis and one with pre-existent multi-organ failure and sepsis. CONCLUSIONS: Pancreatic duct stones may be causally associated with internal pancreatic fistulae. Delineation of ductal anatomy and pathological aberrations of the pancreas, including determination of the leak site, was of paramount importance in planning surgery. Peroperative ductography proved the most useful in this regard.

Adolescent↗

Effect of acute occlusion of left renal vein on the kidney: an experimental study in dogs.

To study the effects of acute ligation of the left renal vein an experimental study was carried out on 16 Mongrel dogs out of 18 of which 2 had died postoperatively. The right kidney served as control. Changes immediately after ligation were recorded; subsequently the dogs were sacrificed in 4 groups comprising 4 in each at intervals of 24 hours, one week, 4 weeks and 6 weeks. Both the kidneys were removed and gross and microscopic changes were noted. In all cases atrophy of the ligated kidney due to tubular atrophy and fibrosis were seen in spite of good collaterals. It is concluded that left renal vein ligation in dogs is not safe for the kidney, though it is not fatal.

Acute Disease↗

Sinusoidal endothelial hyperplasia in pathogenesis of perilobular fibrosis in rabbit after experimental ligation of common bile duct.

Development of perilobular hepatic fibrosis in rabbits after experimental ligation of the common bile duct was studied by microscopy. Twelve hours after the ligation, the lobular boundaries assumed prominence by appearance of row(s) of congested sinusoids around the distended perilobular canals of Hering. Seven days later, the lobular laminae limitans around such canals of Hering revealed myxomatous ballooning degeneration forming well defined inter-lobular bands (ILBs). On day 15 post-ligation, the residual sinusoidal endothelial-lining cells in the ILBs manifested hyper chromasia and occasional mitotic activity. It was followed, on days 25 and 35, by proliferation (hyperplasia) of the sinusoidal endothelium cells forming the portal tract like fibrotic tissue in the perilobular bands. These findings, showed the course of interlobular bridging necrosis along the bile preductules at the lobular circumferences and subsequently indigenous origin of the fibrotic tissue in the ILBs from the residual cells in the affected parenchyma independent of the portal tracts.

Animals↗