ABSTRACT
This report describes a female patient of 45 years with progressive pallor and malaise. Clinically patient was thin built, jaundiced, with palmar erythema and splenomegaly. Her hemoglobin was 4.2g/dL, mean corpuscular volume was 69.2f/ land serum albumin was critically low i.e. 12g/ L. Hypoalbuminemia is a feature of decompensated cirrhosis of liver however such a low level of albumin without peripheral signs of edema has not been reported to the best of the authors' knowledge. It is hereby reported as the first case of its kind
ABSTRACT
To determine the frequency of risk factors of coronary artery disease [CAD] in apparently healthy soldiers of Pakistan Armed Forces. Cross sectional descriptive study. Department of medicine, CMH Okara from July 2012 to Dec 2012. The study included 2215 male currently serving soldiers in age range of 18 to 52 years by consecutive sampling. Relevant history, body mass index [BMI], waist circumference [WC] and blood pressure [BP] of each subject were recorded. BMI > 25 kg/m[2] and WC > 90 cm was considered obesity and abdominal obesity respectively. BP > 140/90 mmHg was defined as hypertension. All the participants of study underwent blood glucose fasting, blood glucose random, ECG recording, personality assessment and lipid profile. Risk estimation was done using Eric Brittain scoring system. In our study group 95.5% patients were having at least 1 risk factor of CAD, 54% were having 2 to 4 risk factors while 3.93% had > 4 risk factors. Risk estimation of CAD using Eric Brittain scoring system showed that a large proportion of study group had high probability of developing ischemic heart disease in next 6 years. A large proportion of our soldiers are harboring risk of CAD due to increase in frequency of 8 conventional CAD risk factors especially obesity
ABSTRACT
To compare the Intubating Conditions and Changes in heart rate [HR] achieved after suxamethonium chloride and rocuronium bromide, during intubation, in patients between ages 11-50 years out of which 4 were in paediatric age group [11-12 years] and 46 in adult group [19-50 years]. This study was conducted at the Armed Forces Hospital Sharourah kingdom of Saudi Arabia during six months period starting from 01/02/09. Fifty patients aged between 11-50 years, 4 including in paediatric age group [11-12 years] and 46 in adult age group [19-50 years], requiring general anesthesia for various surgical procedures, were randomly divided into two groups, i.e. Group A in which Rocuronium bromide, 0.9 mg kg-1 was given for intubation [[n=25] [23 adults, 2 children]] Group B in which Suxamethonium chloride 1.5 mg kg -1 was used for intubation [[n=25] [23 adults, 2 children]] Intubating conditions were observed at 60 seconds after intravenous bolus administration of suxamethonium or Rocuronium. HR was also observed immediately before induction [Pre-Op], at 60 seconds after bolus of Suxamethonium or Rocuronium [Immediately after relaxation], Immediately after intubation and then five minutes after intubation. Intubating conditions were rated as excellent in 96% [n=24 Twenty two adults two children] and good in 4% [n=1 Adult] of the patients who received Rocuronium and excellent in 100% of the patients who received Suxamethonium. There were no statistically significant changes observed in HR at all observation times between the two groups. It is concluded from this study that intubation can be performed under good to excellent conditions at 60 seconds after a bolus dose of Rocuronium of 0.9 mg kg-1. As far as affect on HR are concerned, our study indicate no significant difference between the two drugs. The result of this study indicates that to facilitate intubation using rapid sequence induction technique Rocuronium is a reasonably good alternative to Suxamethonium