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Papers by darshan kumar

Gomal Journal of Medical Sciences, 2016

Among various risk factors, the most important is diabetes and its prime form, type 2 diabetes me... more Among various risk factors, the most important is diabetes and its prime form, type 2 diabetes mellitus (T2DM), and has idiosyncratic connection with coronary heart disease (CHD). Diabetes patients have two- to four-fold higher threat of developing coronary disease than the people without diabetes, and cardio-vascular disease (CVD) is responsible for an irresistible 65-75 per cent of deaths in people with diabetes. Moreover considerably the age and sex-adjusted mortality risk in diabetic patients without pre-existing coronary artery disease was found to be equal to that of non-diabetic individuals with prior myocardial infarction (MI). These incredible results concerning higher risk of mortality have led to doubt that widespread precursors predispose to diabetes and CHD with subsequent implications that insulin resistance, visceral adiposity, and excess inflammation cause the pathophysiology of thrombogenesis. In addition, a complex mix of mechanistic processes such as oxidative str...

The professional medical journal, 2016

Rawal Medical Journal, 2017

Objective: To determine the frequency thyroid dysfunction in patients with type 2 diabetes patien... more Objective: To determine the frequency thyroid dysfunction in patients with type 2 diabetes patients seen at Dow University Hospital, Karachi. Methodology: This observational study was carried out at National Institute of Diabetes & Endocrinology at Dow University Hospital, Ojha Campus, Karachi, Pakistan from January 2015 to December 2015. All type-Il diabetes mellitus (DM) patients with more than 5 years duration were evaluated for thyroid status. All those who had proven thyroid disorder and on treatment, Type 1 DM, patients with gestational diabetes mellitus, fibrocalculous pancreatitis, pancreatitis and steroid induced diabetes were excluded. The laboratory evaluation of thyroid functions was done by estimation of serum T3, T4 and TSH levels. Results: Out of 288 patients, male to female ratio were 1:1.28 and mean age was 51.2+6.18 years (range 30 to 70 years). 119(41.31%) patients suffered DM for 5 to 10 years, 99(34.37%) patients for 5 years and 70(24.30%) had more than 10 years...

Journal of Pharmaceutical Research, 2021

Objective: To evaluate Hepatitis C treatment by directly acting antiviral agents and its impact o... more Objective: To evaluate Hepatitis C treatment by directly acting antiviral agents and its impact on glycemic control. Study Design: This is an observational study. Setting: This study was conducted in Medicine department Civil Hospital Karachi from March 2018 to December 2019. Materials and Methods: Patients visiting the outpatient department of the hospital having Original Research Article Kumar et al.; JPRI, 33(28A): 31-35, 2021; Article no.JPRI.68150 32 documented HCV infection having type 2 diabetes mellitus were included in the study. All participants were given directly acting antiviral treatment for 12 weeks. After treatment they were assessed for achievement of sustained virological response (SVR). Pre-treatment and post treatment fasting blood glucose levels and HbA1c levels were checked. SVR is defined as serum HCV RNA which is undetectable (<50IU/ml) after 12 weeks of antiviral treatment. Results: Around 332 patients matched our inclusion criteria. Amongst these there w...

Among many other causes of death, cardiovascular disease is the most common cause of death in dev... more Among many other causes of death, cardiovascular disease is the most common cause of death in developing countries including Pakistan. Management strategies for cardiovascular disease are constantly developing. These strategies are becoming more and more complicated so physicians should pay attention that they are using suitable diagnostic measures to optimize patient care for example, as progress in the development of effectual methods of myocardial revascularization leads to more minimally invasive and noninvasive procedures, there is a greater need to estimate the possibility of a patient having coronary artery disease by means of noninvasive cardiac testing. Stress testing is a time tested and noninvasive diagnostic technique which plays an important role in the investigation of coronary artery disease. The present piece of work reviews the use of stress testing in the assessment of patients with suspected ischemic heart disease, including the use of risk factor analysis to asse...

The Professional Medical Journal

Objectives: In this study we analyze how much the general population fear from dengue fever based... more Objectives: In this study we analyze how much the general population fear from dengue fever based on their knowledge acquired via media. Study Design: Cross-sectional study. Setting: Civil Hospital, Karachi, Pakistan. Period: 1st August 2019 to 30th September 2019. Material & Method: Non-Probability consecutive sample technique was used. Patients with dengue fever were asked to fill a questionnaire which comprised of demographic variables as well as questions regarding their fear of dengue fever based on their information acquired from media particularly news channels. Results: Out of 2750 patients who underwent dengue serology, 727 came positive for active dengue viral infection. Of them 204 patients required admission. Patients were asked to rate how much they think dengue fever is lethal. The mean of all responses was 7.8 (p<0.005). When asked about the route of transmission 93% answered the correct mode of transmission. 59.4% (n=432) think that dengue fever requires anti-biot...

The Professional Medical Journal

The objective of this study is to Hepatitis C Infection patients leads to type2 diabetes mellitus... more The objective of this study is to Hepatitis C Infection patients leads to type2 diabetes mellitus. Study Design: Cross sectional study. Setting: Civil hospital, Karachi.Period: June 2017 to February 2018. Materials and Methods: We screened 1941 patientsand out of them 328 patients had HCV positive serology. HCV serology status was assessedby checking for HCV antibody. To evaluate incidence of type 2 diabetes mellitus in patients withHCV seropositivity, blood glucose levels of all patients were performed. Patients with cirrhosis,pancreatitis, co-existent hepatitis B and any other co-morbid. According to new diagnosticcriteria by WHO hyperglycaemia is labelled at blood glucose levels of 200mg/dl. Results: Wefound total 328 cases showing HCV seropositivity out of total 1941 patients visiting the outpatientdepartment. There were 213 males and 115 females in the data. The demographic data ofpatients suggests that 53% patients lived in rural areas whereas 47% had their residence inurban a...

The Professional Medical Journal

Journal of Diabetes & Metabolism

Pakistan Journal of Medical Sciences, 2015

Objectives: To determine outcome in primary and secondary glomerular diseases at one year follow ... more Objectives: To determine outcome in primary and secondary glomerular diseases at one year follow up. Methods: Study design is observational cohort, done in outpatient department, Dow Iinternational Medical College, DUHS. All information gathered on a proforma. All patients with dipstick positive proteinuria and clinical glomerular disease were included in study. Patients with no proteinuria were excluded so were patients with stage 5 CKD. Patients were followed for proteinuria and renal insufficiency at completion of one year follow up. Statistical analysis was done on SPSS version 16. Result: Total number of patients who completed one year follow up was 173. Mean age of patients was 51.67+ 10.16 (range 15 to 75 years). Ninety two (53.2%), were males and 81(46.8%) were females , ratio being 1.1: 1.0. Mean weight of our patients was 67.43+ 14.13 Kg, (35 to 107 kg). Commonest cause of glomerular disease in our patient was diabetic nephropathy which was seen in 94.2% patients. Commonest associated problem with glomerular disease was hypertension seen in 66.5% of patients. Four out of 173 patients had stage 5 CKD at end of follow up at one year while quantitativ proteinuria remained same at one year follow up. Conclusion: One year follow up is critical for patients with glomerular disease associated with stage 4 CKD as progression to end stage renal failure may be seen within one year in these patients.

Pakistan Journal of Medical Sciences, 1969

Objectives: (1) To determine frequency of urinary tract infection among pyuric diabetic patients.... more Objectives: (1) To determine frequency of urinary tract infection among pyuric diabetic patients. (2) To determine sterile pyuria frequency among pyuric diabetic patients. (3) To determine factors predisposing to urinary tract infection. Methods: This is a non randomized, prospective observational study done in tertiary care set up of Dow University of Health Sciences, Karachi. Data collection done from June 2013 till August 2013. Sampling was done by convenient method, sample size of 97. Inclusion criteria was all adult (above 16) patients with diabetes mellitus and pyuria (more than 4 pus cells /HPF) whose urine culture report was also available. Verbal consent was sought from patients. All data was collected on a Performa. Data was maintained and analyzed on SPSS version 16. Results: Total number of pyuric diabetic patients in study was 97. Frequency of Urinary tract infection was 59/97 (60.82%), prevalence of culture negative sterile pyuria was found 38/97 (39.17%). Urinary tract infection was found to be more in females with lower urinary tract symptoms and flank pains. Stone disease, obstructed pelvicalyceal system, proteinuria, high serum creatinine and positive nitrites were found more in culture positive patients than in culture negative pyuric patients. Conclusions: Pyuric diabetic patients in our study population were found to have culture positive UTI in 60.82% and culture negative sterile pyuria among 39.17% of patients. UTI was found more in females, in symptomatic patient and with abnormal urinary tract anatomy and function.

Pakistan Journal of Medical Sciences, 2014

Gomal Journal of Medical …, 2010

... The age of the study subjects varied from 22 to 66 years with mean, median, mode and stan-dar... more ... The age of the study subjects varied from 22 to 66 years with mean, median, mode and stan-dard deviation of 34.70, 33.50, 30 and 7.23 re-spectively. ... Ann Intern Med 2003; 139: 761-76. 2. Kyrou I, Chrousos GP, Tsigos C. Stress, Visceral Obesity, and Metabolic Complications. ...

Pakistan journal of pharmaceutical sciences, 2020

CYP2C9 is an important member of the cytochrome P450 gene family involved in the metabolism of 15... more CYP2C9 is an important member of the cytochrome P450 gene family involved in the metabolism of 15% of the drugs including an oral antidiabetic agent sulfonylurea. This study aims to investigate the frequency of CYP2C9*2 and CYP2C9*3 alleles of the gene in the sulfonylurea treated diabetic subjects in Pakistan. Briefly, total 105 patients were included in the study and segregated as control (24) and test (81) based on the clinical manifestations after taking sulfonylurea. Genomic DNA was extracted from blood of the subjects and amplified using CYP2C9 specific primers for exon 3 and exon 7 and then subjected to DNA sequencing. Alignment of the sequences with the reference sequence shows presence of CYP2C9*3/*3, CYP2C9*1/*3 and CYP2C9*1/*2 genotypes in the test cases but only the latter two were found in the control cases. In addition a novel allele, CYP2C9*61 in the heterozygous state, was also identified frequently in the test cases. Molecular structure comparison also showed variati...

Gomal Journal of Medical Sciences, 2016

Among various risk factors, the most important is diabetes and its prime form, type 2 diabetes me... more Among various risk factors, the most important is diabetes and its prime form, type 2 diabetes mellitus (T2DM), and has idiosyncratic connection with coronary heart disease (CHD). Diabetes patients have two- to four-fold higher threat of developing coronary disease than the people without diabetes, and cardio-vascular disease (CVD) is responsible for an irresistible 65-75 per cent of deaths in people with diabetes. Moreover considerably the age and sex-adjusted mortality risk in diabetic patients without pre-existing coronary artery disease was found to be equal to that of non-diabetic individuals with prior myocardial infarction (MI). These incredible results concerning higher risk of mortality have led to doubt that widespread precursors predispose to diabetes and CHD with subsequent implications that insulin resistance, visceral adiposity, and excess inflammation cause the pathophysiology of thrombogenesis. In addition, a complex mix of mechanistic processes such as oxidative str...

The professional medical journal, 2016

Rawal Medical Journal, 2017

Objective: To determine the frequency thyroid dysfunction in patients with type 2 diabetes patien... more Objective: To determine the frequency thyroid dysfunction in patients with type 2 diabetes patients seen at Dow University Hospital, Karachi. Methodology: This observational study was carried out at National Institute of Diabetes & Endocrinology at Dow University Hospital, Ojha Campus, Karachi, Pakistan from January 2015 to December 2015. All type-Il diabetes mellitus (DM) patients with more than 5 years duration were evaluated for thyroid status. All those who had proven thyroid disorder and on treatment, Type 1 DM, patients with gestational diabetes mellitus, fibrocalculous pancreatitis, pancreatitis and steroid induced diabetes were excluded. The laboratory evaluation of thyroid functions was done by estimation of serum T3, T4 and TSH levels. Results: Out of 288 patients, male to female ratio were 1:1.28 and mean age was 51.2+6.18 years (range 30 to 70 years). 119(41.31%) patients suffered DM for 5 to 10 years, 99(34.37%) patients for 5 years and 70(24.30%) had more than 10 years...

Journal of Pharmaceutical Research, 2021

Objective: To evaluate Hepatitis C treatment by directly acting antiviral agents and its impact o... more Objective: To evaluate Hepatitis C treatment by directly acting antiviral agents and its impact on glycemic control. Study Design: This is an observational study. Setting: This study was conducted in Medicine department Civil Hospital Karachi from March 2018 to December 2019. Materials and Methods: Patients visiting the outpatient department of the hospital having Original Research Article Kumar et al.; JPRI, 33(28A): 31-35, 2021; Article no.JPRI.68150 32 documented HCV infection having type 2 diabetes mellitus were included in the study. All participants were given directly acting antiviral treatment for 12 weeks. After treatment they were assessed for achievement of sustained virological response (SVR). Pre-treatment and post treatment fasting blood glucose levels and HbA1c levels were checked. SVR is defined as serum HCV RNA which is undetectable (<50IU/ml) after 12 weeks of antiviral treatment. Results: Around 332 patients matched our inclusion criteria. Amongst these there w...

Among many other causes of death, cardiovascular disease is the most common cause of death in dev... more Among many other causes of death, cardiovascular disease is the most common cause of death in developing countries including Pakistan. Management strategies for cardiovascular disease are constantly developing. These strategies are becoming more and more complicated so physicians should pay attention that they are using suitable diagnostic measures to optimize patient care for example, as progress in the development of effectual methods of myocardial revascularization leads to more minimally invasive and noninvasive procedures, there is a greater need to estimate the possibility of a patient having coronary artery disease by means of noninvasive cardiac testing. Stress testing is a time tested and noninvasive diagnostic technique which plays an important role in the investigation of coronary artery disease. The present piece of work reviews the use of stress testing in the assessment of patients with suspected ischemic heart disease, including the use of risk factor analysis to asse...

The Professional Medical Journal

Objectives: In this study we analyze how much the general population fear from dengue fever based... more Objectives: In this study we analyze how much the general population fear from dengue fever based on their knowledge acquired via media. Study Design: Cross-sectional study. Setting: Civil Hospital, Karachi, Pakistan. Period: 1st August 2019 to 30th September 2019. Material & Method: Non-Probability consecutive sample technique was used. Patients with dengue fever were asked to fill a questionnaire which comprised of demographic variables as well as questions regarding their fear of dengue fever based on their information acquired from media particularly news channels. Results: Out of 2750 patients who underwent dengue serology, 727 came positive for active dengue viral infection. Of them 204 patients required admission. Patients were asked to rate how much they think dengue fever is lethal. The mean of all responses was 7.8 (p<0.005). When asked about the route of transmission 93% answered the correct mode of transmission. 59.4% (n=432) think that dengue fever requires anti-biot...

The Professional Medical Journal

The objective of this study is to Hepatitis C Infection patients leads to type2 diabetes mellitus... more The objective of this study is to Hepatitis C Infection patients leads to type2 diabetes mellitus. Study Design: Cross sectional study. Setting: Civil hospital, Karachi.Period: June 2017 to February 2018. Materials and Methods: We screened 1941 patientsand out of them 328 patients had HCV positive serology. HCV serology status was assessedby checking for HCV antibody. To evaluate incidence of type 2 diabetes mellitus in patients withHCV seropositivity, blood glucose levels of all patients were performed. Patients with cirrhosis,pancreatitis, co-existent hepatitis B and any other co-morbid. According to new diagnosticcriteria by WHO hyperglycaemia is labelled at blood glucose levels of 200mg/dl. Results: Wefound total 328 cases showing HCV seropositivity out of total 1941 patients visiting the outpatientdepartment. There were 213 males and 115 females in the data. The demographic data ofpatients suggests that 53% patients lived in rural areas whereas 47% had their residence inurban a...

The Professional Medical Journal

Journal of Diabetes & Metabolism

Pakistan Journal of Medical Sciences, 2015

Objectives: To determine outcome in primary and secondary glomerular diseases at one year follow ... more Objectives: To determine outcome in primary and secondary glomerular diseases at one year follow up. Methods: Study design is observational cohort, done in outpatient department, Dow Iinternational Medical College, DUHS. All information gathered on a proforma. All patients with dipstick positive proteinuria and clinical glomerular disease were included in study. Patients with no proteinuria were excluded so were patients with stage 5 CKD. Patients were followed for proteinuria and renal insufficiency at completion of one year follow up. Statistical analysis was done on SPSS version 16. Result: Total number of patients who completed one year follow up was 173. Mean age of patients was 51.67+ 10.16 (range 15 to 75 years). Ninety two (53.2%), were males and 81(46.8%) were females , ratio being 1.1: 1.0. Mean weight of our patients was 67.43+ 14.13 Kg, (35 to 107 kg). Commonest cause of glomerular disease in our patient was diabetic nephropathy which was seen in 94.2% patients. Commonest associated problem with glomerular disease was hypertension seen in 66.5% of patients. Four out of 173 patients had stage 5 CKD at end of follow up at one year while quantitativ proteinuria remained same at one year follow up. Conclusion: One year follow up is critical for patients with glomerular disease associated with stage 4 CKD as progression to end stage renal failure may be seen within one year in these patients.

Pakistan Journal of Medical Sciences, 1969

Objectives: (1) To determine frequency of urinary tract infection among pyuric diabetic patients.... more Objectives: (1) To determine frequency of urinary tract infection among pyuric diabetic patients. (2) To determine sterile pyuria frequency among pyuric diabetic patients. (3) To determine factors predisposing to urinary tract infection. Methods: This is a non randomized, prospective observational study done in tertiary care set up of Dow University of Health Sciences, Karachi. Data collection done from June 2013 till August 2013. Sampling was done by convenient method, sample size of 97. Inclusion criteria was all adult (above 16) patients with diabetes mellitus and pyuria (more than 4 pus cells /HPF) whose urine culture report was also available. Verbal consent was sought from patients. All data was collected on a Performa. Data was maintained and analyzed on SPSS version 16. Results: Total number of pyuric diabetic patients in study was 97. Frequency of Urinary tract infection was 59/97 (60.82%), prevalence of culture negative sterile pyuria was found 38/97 (39.17%). Urinary tract infection was found to be more in females with lower urinary tract symptoms and flank pains. Stone disease, obstructed pelvicalyceal system, proteinuria, high serum creatinine and positive nitrites were found more in culture positive patients than in culture negative pyuric patients. Conclusions: Pyuric diabetic patients in our study population were found to have culture positive UTI in 60.82% and culture negative sterile pyuria among 39.17% of patients. UTI was found more in females, in symptomatic patient and with abnormal urinary tract anatomy and function.

Pakistan Journal of Medical Sciences, 2014

Gomal Journal of Medical …, 2010

... The age of the study subjects varied from 22 to 66 years with mean, median, mode and stan-dar... more ... The age of the study subjects varied from 22 to 66 years with mean, median, mode and stan-dard deviation of 34.70, 33.50, 30 and 7.23 re-spectively. ... Ann Intern Med 2003; 139: 761-76. 2. Kyrou I, Chrousos GP, Tsigos C. Stress, Visceral Obesity, and Metabolic Complications. ...

Pakistan journal of pharmaceutical sciences, 2020

CYP2C9 is an important member of the cytochrome P450 gene family involved in the metabolism of 15... more CYP2C9 is an important member of the cytochrome P450 gene family involved in the metabolism of 15% of the drugs including an oral antidiabetic agent sulfonylurea. This study aims to investigate the frequency of CYP2C9*2 and CYP2C9*3 alleles of the gene in the sulfonylurea treated diabetic subjects in Pakistan. Briefly, total 105 patients were included in the study and segregated as control (24) and test (81) based on the clinical manifestations after taking sulfonylurea. Genomic DNA was extracted from blood of the subjects and amplified using CYP2C9 specific primers for exon 3 and exon 7 and then subjected to DNA sequencing. Alignment of the sequences with the reference sequence shows presence of CYP2C9*3/*3, CYP2C9*1/*3 and CYP2C9*1/*2 genotypes in the test cases but only the latter two were found in the control cases. In addition a novel allele, CYP2C9*61 in the heterozygous state, was also identified frequently in the test cases. Molecular structure comparison also showed variati...