Objective: To determine the frequency of dyslipidaemia in type-2 diabetic patients and to compare the frequency of dyslipidaemia in patients with and without microalbuminuria in type 2 diabetes. Study Design: cross-sectional study. Place and Duration of Study: Department of General Medicine, Combined Military Hospital Quetta Pakistan, from Dec 2018 to Jun 2019. Methodology: All patients who fulfilled the inclusion criteria and visited General Medicine department of Combined Military Hospital Quetta with type II diabetes mellitus were included in the study. Blood sample following an 8-12 hours fasting over the last night and 24 hour urine sample for microalbuminuria was collected to assess the outcome i.e. frequency of dyslipidaemia and also its frequency with and without microalbuminuria. Result: A total of 165 patients with type 2 diabetes mellitus were included. Ninety nine (60%) were males and 66 (40%) were females with the mean age of 48.08 ± 7.63 years. Overall, dyslipidaemia was found in 48 (29.1%) patients, dyslipidaemia was noted in 29 (17.6%) with microalbuminuria and 19 (11.5%) without microalbuminuria. Chi-square test revealed that dyslipidaemia was significantly more in patients of diabetes mellites having microalbuminuria than those not having it (p-value=0.01). Conclusion: Abnormal lipid metabolism was present in significantly more in patients with microalbuminuria as compared to those without microalbuminuria suffering from type II diabetes mellitus.

Objective: To determine the myopathy in patients with diabetes taking atorvastatin and look for the factors correlated with the presence of myopathy among these patients. Study Design: Cross sectional analytical study. Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital Rawalpindi from, Jul to Dec 2018. Methodology: A total of 166 patients of both genders with type 2 diabetes mellitus taking atorvastatin for at least three to twelve months were included. Blood samples were drawn and Creatinine kinase (CK) levels were determined by automated analysis by colorimetry. Myopathy was taken as muscle symptoms associated with elevations in Creatinine Kinase at least 10 times the upper limit of normal. Results: Mean age of patients was 51.530 ± 5.70 years with age range from 40-70 years with. Mean duration of diabetes was 6.174 ± 2.27 years, mean duration of taking atorvastatin 7.186 ± 2.17 months and mean creatinine kinase levels were 1760.325 ± 5111.71 IU/L. Males were 68.7% as compare to females 31.3%. Myopathy was seen in 8.4% patients. Long duration of Diabetes Mellitus and atorvastatin use was statistically significantly related with the presence of myopathy. Conclusion: Myopathy was found in a significant number of patients taking atorvastatin. High risk population in our study emerged out to be patients with long duration of Diabetes Mellitus and long use of atorvastatin.

Objective: To determine the association of serum Ammonia levels with severity of grades of hepatic encephalopathy in patients presenting to the department. Study Design: Comparative cross-sectional study. Place and Duration of Study: Emergency Department, Pak Emirates Military Hospital Rawalpindi Pakistan, from Dec 2020 to May 2021. Methodology: This study was conducted on 100 patients presenting with hepatic encephalopathy at the emergency department of our hospital. Based on clinical findings and relevant investigations, a consultant gastroenterologist or emergency medicine physician diagnosed hepatic encephalopathy or the underlying cause. In addition, serum Ammonia levels were done on all the patients at the time of presentation and associated with grades of hepatic encephalopathy and other factors. Results: Out of 100 patients included in the final analysis, 67 were males, and 33 were females. Infection (29%) was the commonest aetiology of hepatic encephalopathy, followed by Constipation (23%). In addition, 59% had normal serum ammonia levels, while 41% had raised ammonia levels in their serum. High grade of hepatic encephalopathy and raised Child-Turcotte-Pugh score were statistically significantly associated with raised ammonia levels in our study participants. Conclusion: Raised serum ammonia levels were a common finding among patients with hepatic encephalopathy. Therefore, patients with a high grade of hepatic encephalopathy and a high Child-Turcotte-Pugh score at the time of presentation should be considered at a higher risk of having hyperammonemia.