Homocystiene profile in elderly

Homocysteine [Hcy] is a sulfurated amino acid an elevated homocysteine level is a marker for a pathogenic process as well as a cause of pathology. It is across sectional study conducted on 91 elderly participants 60 years and older selected from geriatric outpatient clinic and geriatric inpatient departmentthey underwent comprehensive geriatric assessment, and homocysteine [Hcy] level in blood by Enzyme Immunoassay [EIA]. homocysteine not significantly related to age, sex and functional status. Also mean Hcy level is 15.4 micromol/liter. Further studies to evaluate Hcy level in elderly with different ages are recommended

Psychiatric home care, length of hospital stay and risk of rehospitalization in patients suffering from schizophrenia; a case control study in Al Madinah Al Munawarah Region

The effectiveness of the Psychiatric Home Care program versus the traditional, hospital-centered program needs to be evaluated for proper reform of mental health policy concerning schizophrenia. The objective of the study was to compare the length of hospital stay and risk of hospital re-admission in home-based versus the hospital based services for schizophrenic patients at the Psychiatric Home Care [PHC] of the Psychiatric Hospital, Al Madinah Al Munawarah, Kingdom of Saudi Arabia. The study involved comparing 15 schizophrenic patients in a home-based care program for 1 year to the number and length of hospitalization they experienced in the year prior to being admitted to home based care. It also included a control group of 15 schizophrenic patients under hospital-based care. Both groups were followed up for 1 year. Results indicated that the number of hospital admissions significantly decreased in the case of patients receiving PHC. Psychiatric Home Care is superior to hospital based treatment in the management of schizophrenia

Critical care of gynecological and obstetric patients: a decade of surgical intensive care experience

Despite the emergence of therapeutic advances, the morbidity and mortality still occur in the obstetric patients, although intensive care utilization by obstetric and gynecological patient, are still rare compared to the general population. Majority of obstetric patients needed the intensive care therapy compared to gynecological patients. The aim of our study was to know the indications for the intensive care admission by obstetric and gynecological patients, length of stay and outcome of these patients. We retrospectively reviewed the medical records of all obstetric and gynecological patients admitted to our Surgical and Trauma Intensive Care Units [SICU and TICU] from February 1995 to March 2005. Indication for admission, nationality, age, and length of stay in ICU, severity of disease and outcome of these patients were recorded. Data analyzed with SPSS program. A total of 182 patients were admitted to the SICU of the Hamad Medical Corporation in Doha, Qatar, from the Women's Hospital. 159 [87%] patients were obstetric patients and 23 [13%] patients gynecological patients, 126 [69.6%] patients were admitted post Lower Segment Caesarean Section [LSCS]. The most common indication for admission was 73 [39.3%] patients obstetric hemorrhage and Disseminated Intravascular Coagulation [DIC], and then 44 [25.3%] patients of hypertensive disorder of pregnancy. The major anesthesia related indication was scoline apnea, 21[11.6%]. Total three obstetric patients died, two due to severe sepsis and multi-organ failure and one due to cerebral sinus thrombosis, giving mortality rate of 1.66%. Intensive care therapy required by gynecological and obstetric patient is less than the general population. The commonest indication for admission was obstetric hemorrhage, DIC, and hypertensive disorders of pregnancy. The mortality was due to septic shock with multi-organ failure, and cerebral venous sinus thrombosis

Fatal headache of pregnancy: a case report and review of literature

Due to its variable clinical presentation cerebral venous sinus thrombosis [CVST] is a rare, potentially fatal and challenging condition that is more common in females, with pregnancy, puerperium and the use of oral contraceptive being the risk factors identifiable in up to 80% of cases. Hereditary prothrombotic conditions such as protein C and S, antithrombin III deficiency, and anticardiolipin antibodies are responsible for the condition in many patients. Severe headache is the presenting symptom in most cases. A high index of suspicion is needed for diagnosis although newer imaging procedures have led to earlier diagnosis and management with improved outcomes; magnetic resonance imaging with venography is the investigation of choice. The first line of therapy is intravenous heparin and local thrombolysis can be done in cases deteriorating despite adequate heparinization. Decompression craniotomy may be helpful. Here we report a fatal case of CVST in a pregnant lady with severe headache and anticardiolipin antibody syndrome

Computerized azial tomography; sedation versus general anaesthesia in children below five years of age

To evaluate the clinical safety, effectiveness, efficacy and potential side effects of sedation in pediatric patients undergoing computerized tomography by intrarectal thiopentone and to compare this technique with general anaesthesia for computerized tomography in paediatric patients. Interventional and analytical/ comparative study. The study was carried out in Radiology department Combined Military Hospital Rawalpindi over a period of 1 year from Jan 2003 to Jan 2004. Sixty children below 5 years of age were selected by nonprobability convenience sampling and divided into 2 groups A and B, each comprising of 30 children. Group A was sedated by thiopentone sodium that quality of sedation was judged to be adequate in 26 out of 30 patients [86.6%]. Another 2 were sedated but required mild restraint like reposition of the neck leaving 2 with inadequate sedation or an overall failure rate of 6.66%. In group B the success rate was 100% with no observation of any complication. Rectally administered thiopental is a safe and effective sedative for paediatric patients requiring CT scanning in the presence of anaesthesiologist and the failure rate is very low. General anaesthesia makes CT scan more successful with minimal adverse events

Traditional islet cell autoantibodies in diabetic patients with and without long-term complications

The aim of the present work was to demonstrate the presence of the traditional islet cell related autoantibodies in the diabetic patients with and without long term complications and to identify relevant predisposing markers of pre-clinical diabetic complications. There was a significant difference [P 0.001] between the percentage of islet cell autoantibodies [ICA], glutamic acid decarboxylase autoantibodies [GAD-Ab], and insulin autoantibodies [IAA] positive subjects in the diabetic groups and their matched control and potential groups. Type-1 diabetic groups had a higher percentage [P.0.05] of subjects positive for ICA, GAD-Ab, and IAA than Type-2 diabetic groups. The concentration of ICA in the studied population strongly correlated with the duration of the disease [r=0.705, p 0.05]. There was no significant difference [P>0.05] between the percentage of islet cell antigen-2 autoantibodies [IA2-Ab] positive subjects in the different groups of diabetic population and their control. In conclusion the traditional islet cell antibodies have a role in the detection and development of diabetes especially Type-1 rather than the long-term complications. Other more specific autoantibodies and immune responses, which were not studied, may have a role in the etiology and pre-clinical appearance of these chronic complications. KeyWords: Diabetes,Autoantibodies, Complications

Slow arsenic poisoning of the contaminated groundwater users

This paper gives impact of Arsenic contaminated water on human health as well as overview of the extent and severity of groundwater arsenic contamination in Bangladesh. Scalp hair is the most important part of the human body to monitor the accumulation of this type of poison. Therefore, an experiment has been carried out by Neutron Activation Analysis [NAA] at Atomic Energy Research Establishment [AERE], Savar, Dhaka, Bangladesh on human hair of corresponding tube well water users of these areas to determine the total accumulation of arsenic to their body. Hair samples collected from the region where the groundwater was found highly contaminated with arsenic. The obtained results of arsenic concentration in the lower age [Hb] categories of users [below 12 years of age users] is in the range of 0.33 to 3.29 ?g/g [ppm] and that in the Hu categories [upper 12 years of age users] is 0.47 to 6.64 ?g/g [ppm]. Where as maximum permissible range is 1 ppm certified from WHO. Results show that the peoples are highly affected where the groundwater is highly contaminated with arsenic and acts as the primary source of arsenic poisoning among the peoples of those areas. The results indicate that human population is affected with arsenic locally using the contaminated water for a long time

Influence of structure of the cationic polytriethanol ammonium bromide derivatives. II. corrosion inhibition

A series of alkyl polytriethanolammonium bromide derivatives were synthesized and evaluated as corrosion inhibitors using the weight loss method at 25°C. The applicability of these inhibitors was examined using [2M HCl] at 50, 100 and 200 ppm of inhibitor concentrations. The results were correlated to their surface and thermodynamic parameters of adsorption. The results obtained from emulsification and solubilization measurements showed the ability of using these compounds as corrosion inhibitors in oilfields without any risk for occurrence of emulsification or solubilization processes

Open reduction and fixation of proximal humeral fracture and fracture dislocation of the shoulder

Open reduction and internal fixation was employed in the treatment of twenty five displaced fractures and fracture-dislocation of the proximal humerus. Our aims were accurate reduction and stable fixation to allow early mobilization and to achieve fuII functional recovery. In fifteen fractures an AO T-plate was used and in ten a bent semitubular plate was employed as a blade plate. ExceIIent or satisfactory results were obtained in all six patients with two-pan fractures involving the surgical neck, in four of the five patients with three part-fractures involving the surgical neck and tuberosities in nine of the eleven patients with fracture dislocation and in two of the three patients with split fractures of the humeral head. Overall results were good or satisfactory in twenty-one of the twenty five cases. Unsatisfactory results were associated with rotator cuff damage

Toxoplasmosis and abortion: serological co-relation

This study involved the analysis of serum samples and product of conception in 105 females for Toxoplasmosis. The serum analysis for IgM and IgG were done by enzyme immuno assay [EIA] in our population. All human sera were also screened for human immnuno deficiency virus [HIV] to rule out that toxoplasma infection was not due to immuno suppression. The product of conception was used for making wet mount, stained preparation and mice innoculation [with saline control]. One group of mice was sacrificed on 3rd or 4th day and the other on or about 3rd week. Out of the 105 samples tested for IgM antibodies specific to Toxoplasma, 16 [15.2%] were sero-positive [both groups]. Fourteen [25.9%] sera were positive for IgM antibodies in 54 patients having had spontaneous abortion and 35 [33.3%] samples were sero-positive for IgG antibodies out of a total of 105 cases. In AB group there were 27 [50.0%] sero-positive out of 54 screened and in TA group out of 51 cases tested 8 [15.7%] were sero-positive. HIV screening by EIA in both AB and TA groups did not reveal any sero-positive case. HIV result showed that sero-positivity of Toxoplasma was not due to immuno suppression. Product of conception was subjected to wet mount and stained preparation [Alkaline Methylene Blue and Giemsa] in which we observed parasite in 2 cases. Serum study done in mice sacrificed on 3rd or 4th day showed no sero-positivity for IgG and IgM type of antibodies, whereas mice sacrificed on 3rd week gave 2 [3.1%] sero-positivity of IgM and IgG specific to Toxoplasma in AB group out of 54 cases. Wet mount and stained preparation revealed parasites from peritoneal wash of mice sacrificed on 3rd or 4th day. Toxoplasmosis situation in our country is acute and needs launching of national programme for sero-diagnosis of pregnant women and adopting preventive measures to overcome serious consequences of disease

Study of antibodies to hepatitis C virus in cirrhosis of liver and hepatocellular carcinoma

A study of antibodies to Hepatitis C Virus [HCV] was conducted at Department of Microbiology, BMSI, Jinnah Post Graduate Medical Centre, Karachi on 56 patients suffering from cirrhosis of liver and hepatocellular carcinoma. The patients were suffering from chronic liver disease for more than six months and had more than three months persistently/fluctuating raised alanine aminotransferase [ALT] >40 lU/L for male and > 35 lU/L for females. Ten samples from healthy individuals were also included in the study and their ALT were < 40 IU/l for males and < 35 IU/l for females. The prevalence of anti-HCV was found to be 24/52 [46%] in cirrhosis of liver and 1/14 [25%] in hepatocellular carcinoma. The mean ALT was 60.6 lU/L [range 43-165] in cirrhosis of liver and 75.2 lU/L in hepatocellular carcinoma