Objective: To determine the outcomes of newly diagnosed patients of peripartum cardiomyopathy at Liaquat University Hospital, Hyderabad. Methodology: Total 91 patients of peripartum cardiomyopathy were included. A detailed medical history and base line equitable investigations were done. Patients were kept under observation for 7 days during their hospital stay and study outcomes were recorded. Descriptive statistics were calculated. Stratification was done and post stratification chi square test or fisher exact test was applied. Two sided P-value ≤0.05 was considered as significant. Results: The overall mean age was 29.06±4.71 years. Total 73.6% patients were belonged to urban and 26.4% belonged to rural areas. 52.7% patients had normal delivery while 40% had C-section and 6.6% had instrumental assisted deliveries. As far as outcomes are concerned, 65.9% patients had congestive heart failure, 12.1% patients had arrhythmias, 35.2% patients admitted in ICU, 64.8% patients admitted in recovery and 7.7% patients were died. Conclusion: In a prospective cohort with PPCM, most women recovered; however, rates of CHF were observed significantly in patients with diabetes mellitus and hypertension. In-hospital mortality was comparatively less frequent but it was significantly associated in women having age less than 30 years.

Background: Previous studies have established the fact that diabetic patients are predominantly inclined towards silent myocardial infarction (SMI). The objective of the present study is to determine the incidence of SMI in diabetes mellitus (DM) patients. Methodology: In this cross-sectional study, patient data was gathered on a predesigned proforma regarding the detailed history of dyspnea, DM and its duration, chest pain either present or not. Those patients who had normal ECG labeled negative for SMI, while those who had either ST-segment elevation or ST-segment deviation on resting ECG were positive for SMI. Study was conducted at the National Institute of Cardiovascular Diseases (NICVD) Karachi- Pakistan. Results: The mean age of the enrolled patients was 54.21±8.65 (40-70) years. Out of 210, majority were female (51.90%).Overall, 94(44.76%) patients were obese, 122(58.09%) were hypertensive, 90(42.85%) had dyslipidemia and 98(46.66%) diabetic patients were smokers. There were 93 (44.3%) DM patients who had SMI. Moreover, 109(51.90%) patients had a family history of myocardial ischemia. Conclusion:  The SMI incidence among diabetic patients was found higher in local population. It is proposed that diabetic patients with demonstrated cardiovascular autonomic neuropathy must be screened for the manifestation of SMI.

Background & Objective: A simple blood test (urea and creatinine) and a urine test may indicate renal function deterioration and presence of microalbuminuria, which is also the first clinical signs of renal dysfunction in patients with diabetes mellitus. This cost effective test easy to perform even in the absence of advance facilities in a hospital. That is why we planned to conducted this study to assess the comparison between of spot urine protein:creatinine ratio with 24-hour urinary protein in patients with type 2 diabetes mellitus. Materials and Methods: This prospective hospital based clinical study was conducted in the Department of General Medicine, Liaquat University of Medical & Health Sciences, Jamshoro, over a period of six months from 10th May 2018 to 9th November 2019 through a consecutive sampling technique. All the patients having age more than 18 years of both gender, and type 2 diabetes mellitus were enrolled in this study. Three cc blood was taken to determine the serum creatinine levels and twenty-four hour 2ml urine sample was also collected to determine the urinary protein levels. The proteinuria ≥300mg/dl in 24-hour urine sample was considered as significant proteinuria. Kappa statistics was used to find agreement between spot urine protein and 24 hours urinary protein. Results: A total 95 patients were evaluated and their mean age was 41.91±14.29 years, with male predominance (n = 66, 69.4%). Average 24 hour urinary protein was 1216.99±949.51mg and spot-urine evaluation of protein was 1919.12±2129.25mg. The agreement between spot urinary protein creatinine ratio and 24 hour urinary protein was found in 82.1% of cases through Kappa statistics and the calculated agreement between the two procedures was 0.975 which provides sufficient agreement to use spot urine protein:creatinine ratio in routine diagnosis of proteinuria. Conclusion: The study have shown that the protein:creatinine ratio for a random urine sample might be used to rule out the presence of significant proteinuria as defined by a quantitative measure of the 24-hour urine protein excretion.