Objectives: To establish the association of raised LDL levels withvarious risk factors causing cerebral ischemia in stroke patients. Background: Cerebrovascular accident (CVA) is a health concern worldwide. Itcauses enormous disabilities in adult age group, and is 2ndcommonest cause of deaths throughout the world. It has been established thatapproximately 15 million people succumb to stroke each year worldwide, out of this 5 million don’t survive and another 5 million become permanently handicapped and thus put significant burden on catering families. This study was conducted to identify contribution of different risk factorsin causing ischemic stroke in our population. Study Design: Descriptive, purposive case series study. Setting: Medical Unit-IV, Nishtar Medical College/Hospital, Multan. Period: One Year tenure spread between January 2017 to December 2017. Material and Methods: 205 cases between 40-70 years of age includingboth male and female patients with ischemic stroke, irrespective of disease duration were included in study. History of raised BP, previous stroke, history of stroke in family, diabetes and smoking was recorded on pre-designed questionnaire. Body mass index was calculated after noting weight and height of the patient.Venous blood (5 ml) sample was drawn and sent to the pathology laboratory of Nishtar Hospital Multan for estimation of serum LDL level and blood glucose level. Results: Of these 205 study cases, 92 (44.9%) patients were male while 113 (55.1%) patients were female. Mean age of patients in our setting was noted to 51.58 ± 8.05 years. In our study, 50 (24.4%) patients were smokers and 40 (19.5%) had history of hypertension. In our setting, family history of stroke was present in 39 (19%) and previous history of stroke was found in 31 (15.1%). Mean body mass index of our patients was calculated to be 23.17± 2.85 kg/m2and 30(14.6%) cases were obese in our study. Mean fasting blood glucose level was 118.32 ± 23.21 mg/dl(48 (23.4%) had diabetes). Mean low density lipoprotein level (LDL) noted in our study was 109.59 ± 49.15 mg/dl and raised level of LDL was seen in 88 (42.9%) of our study cases. Conclusion: By identifying the share of various risk factors contributing in ischemic stroke, we can target population at risk of ischemic stroke and strict control and regulation of modifiable risk factors we can prevent this ominous condition to occur. Our study results point towards early diagnosis which will ultimately lead to proper management to improve clinical outcome in such patients. Raised levels of LDL were significantly associated with gender, diabetes, hypertension, obesity, family history and previous history of stroke.

Objective: To determine the frequency of dyslipidemia in adults with newly diagnosed essential hypertension. Study Design: Cross-sectional study. Setting: Medical Unit IV, Nishtar Hospital Multan. Period: 25th June, 2022 to 25th Dec, 2022. Material & Methods: Fasting blood samples were taken from an antecubital vein and collected in Vacutainer tubes that had an anticoagulant EDTA from an antecubital vein. An auto analyzer was used to perform an enzymatic analysis on fasting plasma total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), and triglycerides (TG). Results: Among 332 study cases, 221 (66.6 %) were male patients while 111 (33.4 %) were female patients. Mean age of study cases was 50.01 ± 6.75 years. In our analysis, diabetes was found in 99 patients (29.8%). In 147 (44.3%) of the study cases, there was a family history of hypertension. Mean body mass index of our study cases was 27.56 ± 1.92 kg/m2 and 136 (41.0 %) of our study cases were obese. Mean systolic blood pressure was 157.85±15.19 mmHg while that of diastolic blood pressure was 109.35 ± 8.56 mmHg. Mean fasting cholesterol level was 192.86±35.96 mg/dl, HDL 42.58±4.38 mg/dl, LDL 125.43± 10.39 mg/dl and mean triglyceride level was 135.86 ± 13.69 mg/dl and in 181 patients (54.5%) were having dyslipidemias. Conclusion: Among patients with essential hypertension in our investigation, dyslipidemia was observed to be very common. Smoking, diabetes, residential status, and male gender were all strongly linked to dyslipidemia. To prevent future unfavorable cardiac events, which will safeguard patients from acquiring cardiovascular diseases and enhance their quality of life, all clinicians caring for such patients should routinely check their lipid profiles.

Objective: To determine the association of various factors with hypocalcaemia in individuals with decompensated cirrhosis with chronic viral hepatitis etiology. Study Design: Cross Sectional Observational Study. Setting: Department of Internal Medicine, Nishtar Medical University and Hospital Multan. Period: Six Months Extending from July, 2019 to December, 2019. Material & Methods: Sample Size: One hundred and seventy six patients were selected. Results: Among 176 study cases, 97 (55.1%) were male patients while 79 (44.9%) were females. Mean age of our study cases was noted to be 48.85 ± 8.13 years. Of these 176 study cases, 70 (39.7%) were from rural and 106 (60.3%) were urban background. Out of them, 124 (70.5%) were from poor families and remaining 52(29.5%) were middle class. Mean serum calcium level calculated was found to be 7.24 ± 0.87 mg/dl. Hypocalcemia was noted in 152 (86.4%) of our cases. It was seen that there was significant association among gender and hypocalcemia (p-value 0.000), poor socioeconomic status and hypocalcemia (p-value 0.014), obesity and hypocalcemia (p-value 0.009), duration of disease and hypocalcemia (p-value 0.001) treatment status and hypocalcemia (p-value 0.001), viral type with hypocalcemia (p-value 0.000). However no significant relation was discovered among hypocalcemia and age of patient and residential status of patients. Conclusion: We have noticed a very high distribution of hypocalcemia among decompensated cirrhotic having chronic viral hepatitis etiology. We also discovered that hypocalcemia had significant association with female sex, low socioeconomic fragment of society, longer duration of disease, untreated patients and hepatitis C related cirrhosis.