Assessment of immunization status and barriers to vaccination among the university students of Pakistan

A cross-sectional study was conducted to determine the vaccination status and barriers to vaccination among the university students by utilizing a simple random sampling technique in the largest public sector university of Southern Punjab, Pakistan. The participants comprised 380 university students. Data was collected by a self-designed questionnaire. Statistical Package for Social Sciences (SPSS) was used for data analysis. Chi-square Test and Fischer Exact test were applied to assess the impact of demographics on vaccination status, and barriers to vaccination. Out of 380 participants, 328 (86.31 pewrcent) were males and 52 (13.68) females. The immunization status of university students against various diseases was variable: 97.10 percent (n=369) were vaccinated against poliomyelitis, 58.68 percent (n=223) against BCG, 44.21 percent (n=168) against hepatitis B, 49.21 percent (n=187) against diphtheria, pertussis and tetanus and 55.26 percent (n=210) against measles vaccine. The barriers to vaccination were unwillingness 15.0 percent (n=57), inaccessibility 17.10 percent (n=65), financial issues 4.47 percent (n=17) and unawareness 63.42 percent (n=241). Moreover, 31 percent (n=118) of the participants considered that the use of vaccines is unsafe. The vaccination status of the university students in Southern Punjab, Pakistan is alarming as most of the students were unvaccinated. The unawareness and perception of the unsafety of vaccines were the biggest barriers to vaccination(AU)

Se realizó un estudio transversal para determinar el estado de vacunación y las barreras a la vacunación entre los estudiantes universitarios, mediante la utilización de una técnica de muestreo aleatorio simple, en la universidad más grande del sector público del sur de Punjab, Pakistán. Los participantes fueron 380 estudiantes universitarios. Los datos se recopilaron mediante un cuestionario de diseño propio. Se utilizó el Paquete Estadístico para Ciencias Sociales (SPSS) para el análisis de datos. Se aplicaron la prueba de chi-cuadrado y la prueba exacta de Fischer para evaluar el impacto de la demografía en el estado de vacunación y las barreras para la vacunación. De 380 participantes, 328 (86,31por ciento) fueron hombres y 52 (13,68 por ciento) mujeres. El estado de inmunización de los estudiantes universitarios frente a diversas enfermedades fue variable: 97,10 por ciento (n = 369) fueron vacunados contra poliomielitis, 58,68 por ciento (n = 223) contra BCG, 44,21por ciento (n = 168) contra hepatitis B, 49,21 por ciento (n = 187) contra la difteria, tos ferina y tétanos y 55,26 por ciento (n = 210) contra la vacuna contra el sarampión. Las barreras para la vacunación fueron la falta de voluntad 15,0 por ciento (n = 57); la inaccesibilidad 17,10 por ciento (n = 65); los problemas económicos 4,47 por ciento (n = 17) y el desconocimiento 63,42 por ciento (n = 241). Además, el 31por ciento (n = 118) de los participantes consideró que el uso de vacunas no es seguro. El estado de vacunación de los estudiantes universitarios en el sur de Punjab, Pakistán, es alarmante ya que la mayoría de los estudiantes no estaban vacunados. El desconocimiento y la percepción de la inseguridad de las vacunas fueron las mayores barreras para la vacunación(AU)

Metronidazole in acute non-perforated appendicitis

Objective: To compare the infective complication rate after open appendicectomy in patients with nonperforated appendicitis receiving cefazolin with metronizadole and cefazolin alone

Study design: Randomised controlled trial

Place and Duration of study: PAEC General Hospital Islamabad, from March 2015 to June 2016

Methodology: Patients with acute non-perforated appendicitis were divided into two groups. Group A patients received cefazolin with metronizadole and Group B received only cefazolin. A total of three doses were given, one preoperatively and two postoperatively in each group. Patients in both groups were followed up for 30 days postoperatively for any surgical site infections [SSI]

Results: A total of 242 patients were operated of whom 11 were excluded as they did not come for follow-up. There were 111 patients in group A and 120 in group B. Infection rate in group A patients was 7.21 % and in group B, 8.33%. There was no significant difference of wound infection in both the groups [p=0.427]

Conclusion: Addition of metronizadole in patients with non-perforated acute appendicitis did not reduce the rate of surgical site infection

Diabetes mellitus patients; immediate dentures

Objectives: To observe Quality of Life [QoL] in diabetes mellitus patients after fabrication of immediate dentures

Setting: Department of Prosthodontics in Hamdard University Dental Hospital, Karachi

Period: Two years from October 2011 to September 2013

Methodology: Thirty patients with established diagnoses of diabetes mellitus reported. In this study by purposive non-probability sampling technique. In this study patients were selected, male and female patients were 24 and 6 respectively with the age range of 22- 74 years. After getting consent Questions mention in OHIP-14 were asked from the patients on 1[st] visit and 2 months later after fabrication of immediate denture to assess the QoL of in these patients. Data was obtained after using SPSS-version 19. For analysis Wilcoxon Signed Ranks Test was applied to get results. Probability level of P

Results: There was marked improvement in different domains of QoL in diabetes mellitus patients after fabrication of immediate dentures, most of the patients were pleased with their prosthesis. Three patients had complained of pain on buccal side which was corrected by trimming the overextended flange of their denture. All patients had improvement in phonetics [P value 0.01], better choice of food [P value 0.00], eating ability [P value 0.01], decrease embarrassment [P value 0.08] and self-assurance [P value 0.025]. However, effect of immediate denture on variable like tension was not advantageous having P-value of 0.157

Conclusion: By fabrication of immediate dentures to diabetes mellitus patients, QoL can be markedly improved in such patients

Tumour induced osteomalacia

Tumour-induced osteomalacia [TIO] is a rare paraneoplastic syndrome usually presenting with bone pain, fracture of bones and muscle weakness. It is caused by high serum levels of fibroblast growth factor 23 [FGF-23], which is a hormone-regulating phosphate, and vitamin D. FGF-23 is secreted by several tumours, especially benign mesenchymal tumours which are very small and difficult to locate. There is a significant delay from onset of symptoms to the diagnosis of this entity due to occult nature of this disease. We present a case of young male who presented with long history of progressively worsening muscular pain and weakness, rendering the patient confined to bed. Our aim of presenting this patient as a case report is to make physicians realise that any patient with unexplained muscular weakness and pain must undergo workup for TIO, including serum phosphate measurement, as this is a rare but potentially curable disease

Evaluation of number of renal arteries in live related renal donors by CT angiography and conventional angiography

Renal transplantation represents the best available replacement treatment for patients with end stage renal disease patients than performing dialysis, and living donor transplantation has been shown to offer better graft survival than cadaver donor renal transplantation. It was demonstrated that kidneys from living, unrelated donors succeed as well as kidneys obtained from brothers and sisters who share half of the tissue matching antigens with kidney recipients. The study was carried out at department of Angiography, Sindh Institute of Urology and Transplantation [SIUT] from January 2009 to September 2011. A total of 30 patients were included in the study. Informed consent was taken from all patients. Result demonstrates a total of 115 renal arteries in 60 kidneys of donors were depicted at CT angiography [CTA]. Only 57 of kidneys showed more than one or multiple arteries, 52 of these had two renal arteries, and 6 had three renal arteries

Evaluation of patients undergoing transarterial chemoembolization [tace] for hepatocellular carcinoma with respect to tumor size, site and number of lesions

TACE is the combination of two procedures, an infusion of the mixture of chemotherapeutic agents [e.g. doxorubicin, cysplatin, or mytomycin C] and hepatic artery embolization in which particles such as polyvinyl alcohol or gelfoam, are injected simultaneously into selected branches of the hepatic artery supplying the tumor. Hepatocellular carcinoma is rarely seen before the age of 40 years and reaches a peak at around 70 years of age. Owing to its multicentricity, large tumor size and pre-existing cirrhosis most of these tumors were deemed unrespectable at the time of diagnosis. The purpose of this study was to evaluate the tumor size, site and number of lesions that is acquired on hepatic angiogram during TACE of the liver, and compare it with the information provided by pre-interventional contrast enhanced CT images as there is a possibility that CT may not show smaller lesions. This study was carried out in the Department of Angiography, Sindh Institute of Urology and Transplantation [SIUT] from May to October 2011. A total of 30 patients was included in the study. All individuals underwent pre-procedural imaging with contrast material, enhanced CT angiography or MR to ensure that the disease was liver-dominant and to visualize the blood vessels of the liver. This study included 30 patients age ranges 40-80 years, 22 of whom were males and 8 of them were females. HCC had been diagnosed in all patients. Each patient underwent selective Hepatic Chemoembolization in either the right, left or in both lobes.. In comparison to CT, the hepatic angiogram showed 14[46.6%]patients having single lesion, 7[23.3%] were having double lesions and 9 [30%] were having multiple lesions. So the overall sensitivity of hepatic angiogram in the detecting number of lesions is 75% - 80%. The size of 3cm were found in 7[21%] patients and HCC >4cm was found in 15[44.4%] patients.The size of the HCC which we found in most of the patients during our study is >4cm.

Role of investigations and Alvarado score in acute appendicitis at peoples medical college hospital Nawabshah

Role of investigations and Alvarado score in acute appendicitis at Peoples Medical College Hospital Nawabshah. Prospective observational study. Two years study from October 2008 to November 2010. Was conducted in Peoples Medical College Nawabshah. The study comprises 50 patients all were admitted from OPD [Out Patients Department] and COD [Casulty Department]. The patients were evaluated fully after history, clinical examination and specific investigation, blood CP, X-Ray abdomen, supin and erect posture, X-Ray KUB, ultra sound of abdomen and general assessment. All Patients of pain in right iliac fossa included all patients were manage on the basis of Alvarado score, Complete Blood Picture and Ultra Sound report. In this study 50 patients of acute appendicitis in which 25 were female and 25 were male. The maximum of patients were in age group 15 to 40 years. Peak age group 25 years. Out of 50 patients 42 patients were present leucocytosis. On the behalf of Ultra sound report 38 patients were diagnose acute appendicitis. 10 patients were diagnose perforated appendix, 2 patients were diagnose appendicular abscess. 8 patients were present Alvarado score 3 to 4.30 patients were present Alvarado score 6-7, 12 patients were present Alvarado score 8-9, Patients were operated through procedure of appendectomy then tissue sent for histopathology. Acute appendicitis is a common cause of acute abdomen. Anorexia, migrating pain, tenderness and rebound tenderness are evidence of acute appendicitis

Frequency of malignancy in benign enlarge prostate at peoples medical college hospital Nawabshah

To determine the frequency of Malignancy in Benign enlarge prostate. Prospective observational study: Two years study from October 2008 to October 2010. Was conducted in Peoples Medical College Nawabshah. The study comprises 50 patients all were admitted from OPD [Out Patients Department]. The patients were evaluated fully after history, clinical examination DRE and specific investigation of PSA X-ray Lumbo sacral spine Trans rectal, Endo luminal ultra sound flow metery Trans rectal biopsy C.T scan and Bone scan and General assessment. All Patients with enlarged prostate included out of 50 patients 48 patients under went surgery and tissue sent for histopathology. In this study of 50 patients of enlarge prostate total number of patients were in age group 55 to 75 years, Out of 50 patients 9 patients suspected malignant on the basis of DRE. But PSA will raise in 7 patients. Regarding the histopathology the results 7 patients showed malignancy adeno carcinoma. Prostate carcinoma more common enlarged prostate as compared to fibro tic prostate

Effect of wet cupping therapy on virulent cellulitis secondary to honey bee sting - a case report

Cellulitis is clinical condition that is caused by the inflammation of sub-cutaneous tissue. Conventional treatment of cellulites is based on the use of antimicrobials. Treatment by Cupping is one of the oldest ways of healing for more than 5000 years; now remerging in this modern age and is being practice in many countries such as USA, UK, Germany and China. This is the first reported case in which, twice a healthy subject was stung by honeybee and was effectively treated by cupping therapy. In the first attack of honeybee sting, a virulent cellulites developed on the ventral surface of the right forearm. The subject was treated with antimicrobials with no response. Later as an adjunctive treatment, cupping therapy was applied at the site of cellulitis with remarkable and immediate clinical recovery. Interestingly, 45 days later, same individual was applied; that gave quick relief and no inflammation developed. Cupping therapy may be an effective measure in the treatment of honey bee sting induced cellulitis

Surgical site infection in elective sugery

To determine the causes and rate of surgical rate site infection [SSI]. Descriptive study. Surgical Unit II, Peoples Medical College and Hospital Nawabshah, from August 2009 to July 2010. Patients of different wound categories were included in this study and followed up for 30 days postoperatively. The wound infection which occurred within 30 days of operation was considered as surgical site infection. The diagnosis of infection was made on clinical rather than on bacteriological basis. Total number of patients was 300. Out of 212 patients from 12-50 years of age 14 [6.6%] developed SSI, whereas among 88 patients above 50 years, 14 [15.9%] developed wound infection. Most patients had body mass index between 20-28 kg/m[2]. Obesity was more common in females and BMI more than 35 kg/m[2] appeared to be a risk factor for SSI. Most common organisms were Staphylococcus aureus [50%], E. coli [14.3%], Klebsiella [14.3%] and other organisms found in 5-7% cases. Wound infection occurred in 28 [9.3%] patients. The achievable preventive measures should be taken to save the economic burden on patient, hospital and community as a whole

Carcinoma rectum: presentation and outcome of different treatment modalities

To find out different presentations of carcinoma rectum and efficacy of different methods of its treatment. Three years observational prospective case study of 42 cases of Carcinoma of Rectum was conducted in Liaquat University Hospital, Jamshoro and people's Medical College Hospital, Nawabshah from June 2005 to May 2008. All the patients were assessed comprehensively and underwent for surgical intervention accordingly. The age ranged between 20-90 years of the 42 patients with mean age 52 years and male to female ratio was 2:1. 40.4% cases presented with bleeding per rectum and 21.4% with altered bowel habits. More than 50% tumour was located in lower third of rectum. Regarding Duke's classification, 40 [95.23%] were in C and D stages. Out of 42 cases, 21 [50%] were underwent with colostomy, 5 [11.9%] by anterior resection, 7 [16.6%] by abdomino-perineal resection and [11.9%] by Hartman's procedure. Wound infection seen in 28.8%, urinary tract infection in 19.2% and colostomy complications in 20.6%. All the patients with bleeding per rectum should be referred to the hospitals for early evaluation and proper management. Late referral and diagnosis make life miserable with permanent stoma in our social setup

Frequency of malignancy in solitary nodule and multinodular goiter

To determine the frequency of malignancy in solitary nodule as well as multinodular goiter. Prospective observational study. Two years study from November 2006 to October 2008 was conducted in Liaquat University Hospital, Jamshoro and People's Medical College Hospital, Nawabshah. The study comprises 50 patients. All were admitted from OPD of both hospitals. The patients were evaluated fully after history and examinations and specific investigations of thyroid profile, scan, FNAC, indirect laryngoscopey and general assessment. All patients with solitary nodule and multinodular goiter included. Out of 50 patients 49 underwent surgery and tissue sent for histopathology. In this study of 50 patients of nodular goiter, 42 [84%] were female and 8 [16%] were male. The maximum number of patients were in age group 16-70 years. In 27 patients of multinodular 24 were female and 3 male. In 23 patients of solitary nodule 18 were female and 5 male. Regarding the histopathological results 10 [20%] patients showed malignancy, 8 [16%] in solitary nodules and 2 [4%] in multinodular goiter. Papillary.carcinoma seen in 7 [14%], follicular carcinoma in 2 [4%] and 1 [2%] as anaplastic carcinoma. Thyroid malignancy more common in solitary nodule as compared to multinodular goiter

Outcome and management of abdominal trauma at Liaquat University Hospital Jamshoro and Peoples Medical College Nawabshah

Out come and Management of Abdominal Trauma. Prospective observational study. Two years study from September 2006 to December 2008. Was conducted in Liaquat University hospital Jamshoro and Peoples Medical College Nawabshah. The study comprises 50 patients all were admitted from COD [Casualty out Patient: Department] of both hospitals. The patients were evaluated fully after history, clinical examination and specific investigation of X-ray abdomen supine and erect posture ultra sound of Abdomen contrast C.T and D.P.L Diagnostic Peritoneal Levage and General assessment. Al Patients of abdominal trauma included out of 50 patients 46 [92%] Patients an Underwent surgery Laparotomy. In this study of 50 patients of penetrating abdominal trauma 42 [84%] were males and 8 [16%] were Females the maximum number of patients were in age group 16 to 7 years in 40 [80%] Patients had fire arm, were the 6 [12%] cases of stab injury while remaining were the 4 [8%] of Blunt Trauma. Small intestine was the commonest organ injured 13 [26%] fallowed by liver 12 [24%] large intestine 7 [14%], Splenic injury was 7 [14%], Stomach 6 [12%], pan crease in 3 [6%], renal 2[4%]. Abdominal trauma is a serous emergency after Penetrating injury compared Blunt trauma