Concurrent Typhoid Fever and Dengue Hemorrhagic Fever: A Case Report.

Dengue virus can co-infect with a number of viruses, bacteria, and parasites of which dengue malaria co-infection is most well-known. We report a rare case of dengue virus co-infection with typhoid fever and the development of dengue hemorrhagic fever (DHF) during a dengue outbreak. The second spike of high-grade fever following initial defervescence with antibiotic therapy, hemorrhagic manifestations, new onset leucopenia and thrombocytopenia, and evidence of plasma leakage raised suspicion of DHF.

Combination of preconditioned adipose-derived mesenchymal stem cells and platelet-rich plasma improves the repair of osteoarthritis in rat.

To observe the combined effect of platelet-rich plasma (PRP) and preconditioned adipose-derived mesenchymal stem cells (ADMSCs) on the injured articular cartilage of the rat. Animals in the study received an intra-articular injection of PRP and preconditioned ADMSCs, both in combination and separately. The response to therapeutic intervention was evaluated by inflammatory markers, proteoglycans content, chondrogenesis and gene expression analyses.

Echocardiographic Evaluation of Left Atrial Volume Index in Patients with Chronic Kidney Disease.

Chronic kidney disease (CKD) patients are at high risk of developing cardio vascular disease. Left atrial volume index (LAVi) is an indicator of left ventricular diastolic dysfunction. We conducted this study to find out the correlation of LAVi and other echocardio- graphic parameters with estimated glomerular filtration rate (eGFR).

Cardiovascular Autonomic Neuropathy and its Association with Cardiovascular and All-cause Mortality in Patients with End-stage Renal Disease.

Background End-stage renal disease frequently leads to increased cardiovascular mortality. Cardiovascular autonomic neuropathy (CAN) may be predictive of cardiac arrhythmias and sudden cardiac death in patients with end-stage renal disease. Methods A total of 70 patients with end-stage renal disease were included in the study.

Causes of short stature in Pakistani children found at an Endocrine Center.

Background And Objective: Short stature is defined as height below 3 centile. Causes of short stature can range from familial, endocrine disorders, chronic diseases to chromosomal disorders. Most common cause in literature being idiopathic short stature.

A simple integrated primary health care based model for detection of diabetic retinopathy in resource-limited settings in Pakistani population.

Objective: To find out prevalence of Diabetic Retinopathy in general population of three districts in Pakistan.

Methods: A community based cross-sectional survey was conducted in three large districts of Pakistan namely Rawalpindi in Punjab, Peshawar in Khyber Pakhtoonkhwa and Hyderabad in Sindh between January 2013 and August 2015. Lady Health Workers identified individuals at high risk for diabetes based on pre-defined criteria.

High prevalence of preobesity and obesity among medical students of Lahore and its relation with dietary habits and physical activity.

Objective: The objective of this study was to determine the prevalence of obesity among students of medical colleges of Lahore and to study its correlation with high-caloric diet intake and physical inactivity.

Study Design: A cross-sectional survey was conducted at four medical colleges of Lahore, Pakistan between March and June 2012.

Methods: A total of 244 medical students (85 males, 159 females) of the median age of 20 years (range: 18-25) were randomly included in the study.

Turmeric use is associated with reduced goitrogenesis: Thyroid disorder prevalence in Pakistan (THYPAK) study.

Introduction: South Asian population has a particularly high prevalence of thyroid disorders mainly due to iodine deficiency and goitrogen use. There is no data available for prevalence of thyroid disorders in the general population living in nonmountainous regions of Pakistan.

Materials And Methods: A total of 2335 residents of Pak Pattan, Punjab, Pakistan were interviewed about demographic, dietary, medical and environmental history as well as screened for goiter.

Paradoxical respiratory sinus arrhythmia due to a large thoracic empyema in an ambulatory patient.

We report a case of paradoxical respiratory sinus arrhythmia (PRSA) caused by a retro-cardiac empyema in an ambulatory patient. The case describes the dynamics and deleterious impact of PRSA on cardio-respiratory cycle, its electrocardiographic, radiologic and echocardiographic findings. Furthermore, it discusses a probable mechanism of paradoxical respiratory sinus arrhythmia in the setting of a retrocardiac mass and suggests a need for physicians to check for the changes in ventilation perfusion mismatch and rise in physiological dead space in such patients.

Deaths due to dengue fever at a tertiary care hospital in Lahore, Pakistan.

Objective: We conducted this study to review deaths due to dengue fever (DF) during a large outbreak of DF in Lahore, Pakistan.

Methods: We reviewed deaths due to DF at Jinnah Hospital Lahore between August and November 2011. Clinical and laboratory data were abstracted.

An outbreak of pyrimethamine toxicity in patients with ischaemic heart disease in Pakistan.

We investigated an outbreak of darkening of skin, bleeding from multiple sites, leucopenia and thrombocytopenia in ischaemic heart disease patients. Case patients were defined as patients who had received medicines from the pharmacy of Punjab Institute of Cardiology between 1 December 2011 and 12 January 2012 and who developed any one of the following: darkening of skin, bleeding from any site, thrombocytopenia and leucopenia. Clinical and drug-related data were abstracted.

Effectiveness of platelet transfusion in dengue Fever: a randomized controlled trial.

Background: Scientific data regarding effects of platelet transfusion on platelet count in dengue-related thrombocytopenia is scanty.

Methods: A single center, randomized non-blinded trial was conducted on adult patients with dengue fever and platelet counts less than 30,000/μl. Patients were randomized to treatment and control group.

Concurrent dengue and malaria infection in Lahore, Pakistan during the 2012 dengue outbreak.

Introduction: We conducted this study to determine the frequency of malaria and dengue-malaria co-infection in patients admitted to our hospital as 'probable' cases of dengue fever during the 2012 outbreak of dengue, and to ascertain whether dengue-malaria co-infection was more severe than either infection alone.

Methods: This cross-sectional observational study was conducted at Jinnah Hospital Lahore, Pakistan between August and November 2012. Patients with 2-10 days of fever and with two or more of the following: myalgia, arthralgia, retro-orbital pain, headache, skin rash, and hemorrhagic manifestations plus thrombocytopenia and leukopenia, were classified as probable cases of dengue fever and were subjected to reverse transcriptase (RT)-PCR and/or dengue-specific IgM by ELISA.

Expanded dengue syndrome: subacute thyroiditis and intracerebral hemorrhage.

Background: Although most symptomatic dengue infections follow an uncomplicated course, complications and unusual manifestations are increasingly being reported due to rising disease burden. Expanded dengue syndrome is a new entity added into World Health Organization (WHO) classification system to incorporate this wide spectrum of unusual manifestations. We report a case of expanded dengue syndrome with subacute thyroiditis and intracerebral hemorrhage.