Accuracy of various iron parameters in the prediction of iron deficiency anemia among healthy women of child bearing age, Saudi Arabia

Iron deficiency is still considered the most common nutritional deficiency worldwide and the most significant negative consequence of iron deficiency is iron deficiency anemia [IDA]. This study elucidates if IDA among healthy women of child bearing age could be predicted by various iron parameters, using serum ferritin as a gold standard. Between January and June 2009 at primary care clinics of a teaching hospital in Saudi Arabia, 112 anemic [Hemoglobin

Testicular abscess caused by salmonella para-typhi

This case is the first report of a bacteriologically proven testicular abscess in a child caused by Salmonella paratyphi 'A' in Pakistan that clinically simulates a testicular tumour. The case also emphasises that a course of 2 weeks antibiotic is sufficient for testicular abscess if complete surgical debridement is done. Keywords: Salmonella paratyphi 'A', Testicular Abscess, Tumour

Frequency of gall bladder carcinoma in patients undergoing surgery for cholelithiasis

To determine the frequency of gall bladder carcinoma in patients undergoing surgery for cholelithiasis at Isra University Hospital, Hyderabad, Singh- Pakistan. This was a descriptive study, conducted from April 2006 to March 2008 at Isra University Hospital Hyderabad, Pakistan. This study included 200 cases of cholelithiasis who underwent cholecystectomy at out Hospital. Patients belonged to both sexes having cholelithiasis, diagnosed on the basis of clinical grounds and supported by ultrasonography. A uniform procedure of history taking, physical examination, investigations and treatment was adopted for all the patients, and data were recorded on the pre-designed proforma. Of 200 cases that were operated for gall bladder stone disease, eight were found to have carcinoma of gall bladder i.e. frequency was 4%. The age ranged from 35 to 70 years, with mean 50[ +/- 5.3] in females and 56[ +/- 2] in males. Male to female ratio was 1:3. On ultrasound, only three [37.50%] patients with advanced disease had a pre-operative clue of carcinoma. The frequency of gall bladder carcinoma in our population seems much higher than Western populations. Females are more affected than males by this problem. Ultrasonography can miss malignant lesions; therefore every gall bladder specimen should be subjected to histopathology. While in unsuspected cases undergoing laparoscopic cholecystectomy, gentle handling of the gall bladder is critical to avoid port site implantation caused by spillage of bile

In hospital outcome of acute myocardial infarction in patients receiving Streptokinase

To study and compare the in-hospital mortality due to acute myocardial infarction in patients receiving thrombolytic [streptokinase] therapy versus those who were not thrombolysed. This descriptive observational study was conducted at the Coronary care Unit and Cardiology ward of Nishtar Hospital, Multan, from 10 of October 2002 till 30th of April 2003. Four hundred and thirty four patients of acute myocardial infarction who fulfilled WHO criteria of acute myocardial infarction were included in the study. Patients were divided into two groups: patients receiving streptokinase [SK] group and patients not receiving streptokinase [Non-SK] group. In-hospital mortality was our primary endpoint. Mechanical and electrical complications occurring in-hospital after acute myocardial infarction were secondary endpoints. Only 47% patients received streptokinase while 53% did not receive it because of delayed presentation or some other contraindication to streptokinase therapy. Mean age of the SK group was 51.58+11.02 years and Non-SK group was 55.78+10 years. In SK group 170[83.3%] patients were males and 34[16.7%] were females. Only 54[26.5%] diabetics and 150[73.5%] non-diabetics received streptokinase. Streptokinase recipients reached the hospital earlier; mean time of onset of symptoms till arrival at the hospital was 4 hours and 25 minutes while non recipients took a longer time in reaching to the hospital. There was no significant difference in the infarct territory between the two groups. The Non-SK group had higher Killip class as compared to SK group on presentation to the hospital. In-hospital mortality was 8.3% in SK group and 24.3% in Non-SK group [p<0.0001]; left ventricular failure occurred more frequently in Non-SK group and was the most common cause of death in both the groups [p<0.0001]. Only 4.3% patients in the SK group and 19.6% patients in the Non-SK group died in first 24 hours of hospital admission [p<0.0001]. Mechanical complications occurred more frequently in Non-SK group [p<0.008]. There was a statistically non significant difference [p<0.436] noted in comparison of electrical complications between the two groups. Streptokinase infusion given in the early hours of acute myocardial infarction leads to a significant reduction in in-hospital mortality and mechanical complications like left ventricular failure

Electrocardiographic patterns of Atrial Septal defects

This study was designed to evaluate the electrocardiographic features of Atrial Septal Defect to establish an association with crochetage pattern and incomplete RBBB. ASDs of Primum, Secundum and Sinus Venosus type were included in this study. From October 15, 2003 till January 15, 2004, a total of 104 consecutive patients of ASD were studied at Punjab Institute of Cardiology, Lahore. Patients were included in the study after confirmation of Atrial Septal Defect on transesophageal echocardiography. The mean age of the study population was 26.28 +/- 11.40 years. Among these 56[53.8%] patients were females and 48[46.2%] patients were males. The study population consisted of 94[90.4%] Secundum ASD patients followed by Sinus Venosus ASD 8[7.7%] patients and Primum ASD in only 2[l.9%] patients. Only 59[56.7%] patients had crochetage pattern in any of the leads while it was absent in 45[43.3%] patients p=0.470. Incomplete RBBB was present in 92[88.4%] patients. It was observed in 2[1.9%] patients in ASD Primum, 82[78.8%] patients in ASD Secundum and 8[7.7%] patients in ASD Sinus Venosus type. P=0.483. Although we did not observe a statistically significant association between crochetage pattern or incomplete RBBB and ASD but the presence of any of these two considerably increases the specificity of the ECG for the diagnosis of ASD

Incidence of dry socket in lower jaw at a teaching dental hospital

The objective of the study was to determine the incidence of dry socket after extractions in lower jaw in Oral and Maxillofacial Surgery [OMS] Department during six year period at Dental Section, Nishtar Medical College, Multan, Pakistan. Hospital record of all the patients who underwent forceps / elevator dental extractions during the selected period was examined for dry socket complication. The patients who were medically compromised and third molar extraction patients were excluded from the study. Among the total of 32811 simple dental extractions during the six year period, 1163 [3.5%] extraction cases suffered from dry socket with 696 [2.1%] in lower jaw and 467 [1.4%] in upper jaw; the difference between lower and upper jaw was statistically significant [p=. 0001]. The mean age of the dry socket patients was 33 years ranging from 17 -49 years. Out of 1163 dry socket patients; 429 were male and 734 were female; showing a ratio of 1: 1.7 [p=.0001]. It can be concluded that incidence of dry socket was significantly higher [p=0001] in lower jaw as compared with upper jaw. Similarly; dry socket incidence was significantly higher in female as compared with males

Cytological and histological correlation of solitary thyroid nodule

To assess the role of fine needle aspiration cytology [FNAc] in the management of solitary thyroid nodule and to correlate the FNA cytodiagnosis with histopathological results of surgically excised specimens of thyroid. It was a retrospective study. This study was carried out at Jinnah Hospital Lahore in the year 2006. In this period patients files and slides were retrieved from record. Both FNA cytolodiagnosis and histopathological results were correlated. Out of these 64 cases, 5 cases were diagnosed malignant on histology. These were 2 cases of papillary carcinoma, 2 cases of Non Hodgkin's lymphoma [NHL] and I case of follicular carcinoma I case of NHL and 2 cases of papillary carcinoma were correctly diagnosed on FNA. 1 case of NHL was misdiagnosed as benign cystic lesion of thyroid on FNA and I case in which cytodiagnosis of hyperplastic colloid nodule/follicular neoplasm was made, turned to be follicular carcinoma on histology. In the remaining 59 benign cases, a wide range of overlap was seen among benign thyroid lesions. Despite, the overlap of the spectrum of cytological features of different thyroid lesions, FNA cytological examination of solitary thyroid nodules is strongly recommended

Third molar impaction: a review

Impaction is the failure of a tooth to erupt within due time due to obstruction by bone or adjacent tooth [teeth], overlying soft tissue, and lack of space which may occur due to tooth-jaw size discrepancy. Impaction most commonly occurs in third molars, more in mandibular than maxillary third molars followed by maxillary canines. Other teeth may become affected. However, as the third molar is the last tooth to develop and erupt in the oral cavity, it readily becomes impacted or displaced if there is insufficient space in dental arch. Third molar impaction should be treated as soon as it becomes apparent it will not properly erupt, and removed earlier to reduce morbidity and promote rapid healing. Nevertheless, many factors have to be considered while dealing with third molar impactions. The purpose of this review is mainly to provide basic information to general practitioners on the topic, so that they can recognize the condition early, manage wherever possible, and make appropriate referrals when indicated. This is a review article

Comparative study of blood pressure levels in local healthy male sedentary people and manual workers

To compare the levels of blood pressures in local sedentary and manual male workers. Design: Sedentary, light and heavy manual workers were randomly selected on the basis of their occupational activities for the last five years. Setting: Department of Physiology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi. Subjects: Seventy three male apparently healthy subjects from three occupational groups of approximately the same age, weight and height. Main outcome measures: Body mass index [BMI], weight, pulse rate and blood pressure levels were measured manually while their fasting glucose and haemoglobin levels were determined chemically. Significantly higher [P<0.05 and 0.001] pulse rate, systolic and diastolic blood pressures were observed in sedentary subjects as compared to light manual and heavy manual workers. However, when light manual workers were compared with heavy manual workers, only the diastolic blood pressure was found to be significantly lower [P<0.05] in heavy manual workers. Non-significantly [P>0.05] different levels of haemoglobin [13.9 +/- 0.1 4 vs 13.6 +/- 0.1 5 g/dl] and blood glucose [84.3 +/- 1.15 vs 85 +/- 0.85 mg/dl] were observed in sedentary and manual workers, respectively which were within normal limits. Conclusions: Occupational physical activity has beneficial effects on pulse rate and blood pressure levels. And there is an increased likelihood of coronary artery disease associated with reduced physical activity

Congenital dislocation of the knee: a review of four cases

Congenital dislocation of the knee [CDK] is a very rare condition, the incidence not being known with certainty. The etiology is also unknown. We reviewed four patients with severe CDK during the period of 1974-1986. The male/female ratio was 3:1. Three had bilateral and one unilateral dislocation. All were treated initially conservatively. Later three knees were operated upon. All treated knees have full range of movements except one which had secondary infection. The maximum follow up period [one case] is 12 years