Clinicicopathologic profile of patients presenting with abdominal tuberculosis in a tertiary care hospital

To evaluate pattern of presentation of patients with abdominal tuberculosis [TB] in a tertiary care hospital. This was a hospital based non-interventional descriptive case series study. It included patients of both sexes, more than 12 years of age, with clinically suspected abdominal tuberculosis. The study was carried out in medical wards of Lady Reading Hospital, Peshawar from January to December 2003. Patients were selected by non-probability convenient sampling method after obtaining an informed consent. Out of 100 patients with abdominal TB, there were 62 [62%] patients with intestinal TB, 30 [30%] with peritoneal TB and 08 [08%] patients with nodal TB. The mean age of patients was 36.4+9.64 years. Fever was observed in 74 [74%] patients, weight loss in 42 [42%], abdominal pain in 72 [72%] diarrhoea in 53 [53%], vomiting in 49 [49%], abdominal mass in 34 [34%], and ascites in 36 [36%] patients. Montoux test was positive in 67 [67%], immuno-chromatographic testing [ICT] for Tuberculosis., was positive in 62 [62%] patients. Chest radiograph was abnormal in 24 [24%] patients, Abdominal Ultrasonography showed abnormalities in 72 [72%] patients.. Barium contrast studies showed abnormalities in 77 [77%] patients. Computerized tomography [CT] of the abdomen was abnormal in 84 [84%]. Intestinal tuberculosis was the most common entity in patients with TB abdomen. The most frequent presenting features of abdominal TB were fever and abdominal pain. CT abdomen had the highest diagnostic yield

Relation of smoking and elevated homocysteine in patients presenting with acute coronary syndrome

Elevated plasma homocysteine levels. homocysteine levels are risk factor for coronary artery disease. Smoking is known to be Other risk factors like diabetes mellitus, associated with an increased plasmafamily history, obesity and dyslipidemia were homocysteine level and both with increased riskalso studied. of cardiovascular disease. To investigate the relation ship between smoking, plasma homocysteine and other conventional risk factors with coronary artery disease in relatively younger population of patients presenting with acute coronary syndrome in emergency room of Cardiology Department, Allied Hospital Faisalabad. Among 586 patients of ACS under 50 years, 221[38%] patients were found to be smokers. Smoking habit showed significant difference between male and female patients as 177 [80%] male and 44 [20%] female. Homocysteine level of 22.4% patients among all was high and was found associated [63.5% of smokers] with smoking habit Out of 1852 consecutive patients[P<0.01]. Hypertension was not among admitted in emergency room of Cardiologysignificant factors for smokers as 421 [65%] Department, Allied Hospital Faisalabad overwere not suffering from hypertension. There one year, 1375 [74%] presented with acute chestwere 93 obese among smokers and these two pain, 586 were under 50 year. 384 [66%] wererisk factors collectively posed insignificant males 202 [34%]. 200 [34%] were under 40effect [P<0.05]. years. 386 [66%] patients were in age range 41 - 50 years. The demographic details, history and clinical examination of patients were recorded and their blood was collected in fasting state for estimation of serum total cholesterol, plasma glucose and serum total It was concluded that smokers were more prone to have coronary heart disease due to increased levels of homocysteine, its association with abnormal lipid profile and especially when some other risk factor combines with smoking greatly increases the risk of cardiovascular disease and should therefore be offered intensive advice to help them cease smoking also have reduced levels of homocysteine

attitude and perception of hospital doctors about the management of psychiatric disorders

To determine perception and the attitude of non-psychiatric doctors about psychiatric problems working in a tertiary care hospital. Cross-sectional survey. Postgraduate Medical Institute, Lady Reading Hospital, Peshawar. The questionnaires distributed were returned within one week duration. All the doctors working in Lady Reading Hospital, Peshawar for more than one year except house officers and those working in Paediatrics, Radiology and Administration Block were given anonymous questionnaires. Two hundred and ten doctors returned the questionnaires. One hundred and eighty-three [87%] of respondents were male. Ninty-eight percent of doctors agreed that psychological factors were important in the cause and outcome of physical disorders but only 26.7% agreed that management of emotional issues is medical responsibility. There was no statistically significant difference between physicians and surgeons in their attitude towards importance of psychological factors in the physical disorders. Doctors working in tertiary care hospital have adequate awareness about the psychological and emotional factors in medical and surgical patients. However, some barriers against the provision of bio-psychosocial care seem to be present