Comparison of oral versus injectable vitamin-D for the treatment of nutritional vitamin-D deficiency rickets

To assess the safety and acceptability of a single dose of vitamin-D versus the efficacy of injectable Vitamin-D versus oral vitamin-D. Case control. It was carried out at the Department of Paediatrics, Kharadar General Hospital, Karachi, from August 2003 to April 2004. Children of the age of 6 months to 3 years with clinical, biochemical and radiological evidence of vitamin-D deficiency rickets were included. The history, clinical examination, complete blood picture, serum calcium. Phosphorus, alkaline phosphatase and X-ray of wrist joint were done. The children were divided into two groups A and B. Group A was given oral vitamin-D and group B was given intramuscular injection of vitamin-D on the first day and then they were followed for two more visits at 30 and 90 days with clinical, biochemical and radiological examinations to assess the outcome. There were 50 confirmed cases of rickets in each group. The mean age was 10.9 +/- 5.1 months and 14.7 +/- 8.1 months in group A and B respectively. In these children, clinical features were weakness, difficulty in walking, frontal bossing, ribcage deformity and widening of wrist were seen. After one dose of vitamin-D [cholecalciferol], there was appreciable gain of weight and height and raised levels of alkaline phosphatase became normal during follow-up. Radiological florid rickets and non-florid rickets in both groups healed clinically during follow-up period. Oral and injectable forms of vitamin-D [cholecalciferol] were effective but injectable form was shown to be statistically significant. There were no undesirable side effects and both forms of treatment were well-tolerated

Prevalence of hepatitis B infection in pregnant women in a tertiary care hospital

The purpose of this study was to determine the prevalence of hepatitis B among pregnant women, and to study acceptance and compliance of hepatitis B screening program during the five year period. A five year, descriptive cross sectional study of screening for hepatitis B infection of routine prenatal laboratory testing during antenatal registration. Compliance with the programme was evaluated by checking delivery and laboratory records of the hospital. Study Period January 1 2002 to December 31, 2006. Kharadar General Hospital [KGH] Karachi. During the last five years 34, 918 women registered for antenatal care at KGH. Out of these 25, 482 women accepted to be screened for hepatitis B virus. A total of 401 women were found to be hepatitis B surface antigen positive. The overall prevalence was 1.57% during this period. We found a rising trend in the acceptance of the hepatitis B screening among pregnant women coming for antenatal care from 42% in 2002 to 96% in the year 2006. [p value <0.001]. We also observed an overall decrease in the prevalence of seropositive cases observed, probably due to the administration of hepatitis B vaccination in the postpartum period. Prevalence of seropositivity of hepatitis B was 1.57% among pregnant women at KGH. Secondly, there was a higher trend in acceptance of hepatitis B screening among pregnant women during the antenatal period

Hand-assisted laparoscopic surgery for colorectal malignancies

To report our initial experience with hand-assisted laparoscopic surgery [HALS] for colorectal malignancies using a specially-designed laparoscopic hand cannula. Patients and Nine caucasians patients with colorectal malignancies underwent HALS which included 02 right hemicolectomies, 01 transverse colectomy, 03 sigmoid colectomies, 01 anterior resection and 02 low anterior resections. There were 4 males and 5 females. The mean length of incision for placement of the cannula was 7 cms [range 7-8 cms]. The mean operating time was 180 minutes. Postoperatively on an average patients were ambulatory by day 2 [range 1-4] and taking oral fluids by day 3 [range 1-4]. There were no conversions to laparotomy. Furthermore there was no operative mortality and no complication directly related to the use of the device. HALS appears to be a useful adjuvant for laparoscopic colectomy due to advantages provided by tactile sensation. A curative resection for malignancy can be performed without compromising oncological principles

Efficacy, safety and tolerability of psyllium hydrophilic mucillpod in mild to moderate hypercholestrolemia

Coronary heart disease is the leading cause of death. Hypercholesterolemia and specially increased LDL cholesterol is the major risk factor in coronary heart disease. Psyllium hydrophilic mucilloid [PHS] is used for decades as laxative agent for the treatment of constipation. Now its role in reducing cholesterol level is well established. We used PHS as adjunctive to low fat diet and we found it effective, safe and well tolerable in patients with mild to moderate hypercholesterolemia. Psyllium [PHS] 3.4 G three times daily as adjunctive to low fat diet reduced total cholesterol and LDL cholesterol by 12.1% and 20.8% with mild transient gastrointestinal disturbances

Effects of methysergide on serotonin and secretagogues treated gastric secretion in intact pylorus ligated rats of different age groups

To study the effect of antiserotonin drug methysergide on the serotonin and secretagogues on gastric acid secretion in younger and older age animals. Setting: The study was conducted at the pharmacology department, Basic Medical Science Institute, Jinnah Postgraduate Medical Centre, Karachi. Pylorus ligated rate stomach preparation was done on 48 hours starved animals. Drugs were administered, 4 hours latter on rat was sacrified. After opening abdomen, oesophagus was ligated and stomach removed. Contents of stomach were flushed with 3ml distilled water. The contents were used to determine the volume of gastric juice and free and total acidity by titration. Result: Methysergide significantly blocked the gastric inhibitory action for serotonin in the presence of histamine and bethanechol and values were found increased in older animals than younger. But when secretagogue was pentagastrin icnreased values were insigificantly found in older animal against younger. The effect of methysergide, serotonin, histamine and bethanechol on gastric juice volume and acidity is according to parietal cell mass which increases with advancement of age of animals. While pentagastrin's stimulatory action in the presence of serotonin and its antagonist is insignificantly higher in older animals

Efficacy and safety of mebendazole in children with worm infestation

Children aged between 2-16 years, were screened for worm infestation. Fifty-five children fulfilling the inclusion criteria were included in the study. They were treated with mebendazole 100 mg twice daily for three consecutive days and followed-up for 15 days to assess cure rate and side effects. Fifty children completed the study with their stools being tested by direct smear and concentration methods and blood CBC done before treatment and at the end of the study. The cure rate for ascaris was 100% and for trichuris 75%. The drug was well tolerated and apart from mild diarrhoea occurring in 22% children, no untoward effects were reported. Nemazole [mebendazole] has shown promise and seems useful in treating children with worm infestation