Frequency of congenital heart diseases in neonatology section of a tertiary care hospital Peshawar

To determine the frequency of common congenital heart diseases [CHD] in children presenting to Pediatrics, Department of Lady Reading Hospital, Peshawar. Cross sectional descriptive study. This study was conducted in the Pediatrics and Neonatology Department of Lady, Reading hospital Peshawar, from 14[th] July 2010 to 14[th] July 2011. A total of 481 patients, using 3.1% propotion of ASD in cases with CHD, 95% Confidence interval, 1.55% margin of error, under WHO software formula for sample size determination. Children from 0-18 years of age clinically diagnosed cases with their echocardio-graphy which was also suggestive of CHD were included in this study. Postoperative cases of CHD as they require different kind of management plan and Confirmed cases of CHD were excluded. Patients with acyanotic CHD were 416 [86.48%] and with cyanotic CHD were 65 [13.52%]. Cases of ventricular septal defect [VSD] were 190 [39.5%] and amongst them 120 [63.16%] were males and 70 [36.8%] were females. Cases of atrial septal defect [ASD] were 146 [30.35%] and amongst them 63 [43.15%] were males and 83 [56.84%] were female. Thus, there was a female preponderance of ASD patients as compared to VSD. As for patent ductus arteriosus [PDA] there were 80 [16.63%] cases and of transposition of great arteries [TGA] were 30 [6.23%]. Whereas cases of tetrology of fallot [TOF] were 35 [7.27%]. Congenital heart defects [CHD] are among the most common birth defects and are the leading cause of birth defect-related deaths. VSD is the commonest acyanotic CHD whereas TOF is the commonest cyanotic heart disease

Efficacy of percutaneous nephrostomy for management of pyonephrosis

To evaluate the efficacy of Percutaneous Nephrostomy [PCN] for the management of pyonephrosis. This descriptive study of 78 cases of pyonephrosis was conducted at Institute of Kidney Diseases Hayatabad Medical Complex, Peshawar Pakistan from July 2010 to December 2011. Ultrasound guided percutaneous nephrostomy was performed and pus was sent for culture and sensitivity. Urine output in the PCN was monitored. Patients were clinically observed. Blood chemistry was analyzed. Patients were put on antibiotics based on culture and sensitivity. Efficacy was defined as the symptomatic relief of a patient in respect to pain and fever and biochemical improvement in terms of decreased TLC count and improved RFTs in early post PCN period. Data was collected on a structured proforma and was analyzed on SPSS version 10. Out of 78 patients who underwent percutaneous nephrostomy for pyonephrosis, 42[53.84%] were male and 36[46.15%] were female. The majority, 69[88.46%] patients had underlying obstructing urinary calculi. Other causes of obstruction included, benign strictures 5[6.41%]; pelviureteric junction obstruction 3[3.84%] and malignant stricture 1[1.2%]. Culture of the drained pus was positive in 73[93.58%] patients. After 2 to 3 weeks of PCN, 53[69%] patients underwent minimally invasive procedures as definitive treatment of the obstructing lesion whereas 23[31%] patients required major surgery after 4 to 6 weeks. Percutaneous drainage for pyonephrosis is an effective diagnostic and therapeutic method, decompressing the obstructed and infected pelvicaliceal system and rapidly stabilizes the patient's clinical condition and makes him fit for definitive treatment

Serodiagnosis of dengue infection using rapid immunochromatography test in patients with probable dengue infection

To determine the frequency of seropositive dengue infection using rapid immunochromatographic assay in patients with probable dengue infection as per WHO criteria. A cross-sectional observational study was conducted at Abbasi Shaheed Hospital, Karachi from July 2008 to January 2009. Patieats presenting with acute febrile illness, rashes, bleeding tendencies, leucopenia and or thrombocytopenia were evaluated according to WHO criteria for probable dengue infection. Acute phase sera were collected after 5 days of the onset of fever as per WHO criteria. Serology was performed using rapid immunochromatographic [ICT] assay with differential detection of IgM and IgG. A primary dengue infection was defined by'a positive IgM band and a negative IgG band whereas secondary infection was defined by a positive IgG band with or without positive IgM band. Among 599 patients who met the WHO criteria for dengue infection, 251[41.9%] were found to be ICT reactive among whom 42 [16.73%] had primary infection. Secondary infection was reported in 209 [83.26%]. Acute phase sera of 348 [58.09%] were ICT non reactive. Four patients died because of dengue shock syndrome among which three had secondary infection. Early identification of secondary infection in acute phase sera using rapid ICT is valuable in terms of disease progression and mortality. However in highly suspected cases of dengue infection clinical management should not rely on negative serological results

Color vision deficiency in medical students of Karachi

This study was designed to find out the prevalence of color blindness in the medical students of Karachi. Total of 550 medical and dental students was tested for color blindness. Ishihara pseudo-isochromatic color plates were used to find out any colour vision defect in the participants. Among them 365 were females and 185 were males. Out of 550 students 11[2%] were found to have color blindness, out of which 10 [5.4%] were males and 01[0.27%] were females. The prevocational screening for color vision is highly recommended; early in educational life because for some potential medical students, the handicap is so severe that a change in their proposed course of study is often advisable

Orthopedic implant failure a retrospective review of 100 cases

Internal fiuxation with various devices for the repair of fractures is widely used in orthopedic surgery. A stable osteo synthesis obtained which allows early mobilization and promotes fracture healing. however these are not free from complication; many of them are due to poor surgical technique and/or inadequate monitoring. Breakage due to fatigue of the material is riot un common in our setup, where there is no any quality control system. A review of too cases was made who reported to OPD section of department of orthopedic surgery Bolan Medical College Quetta, Initially operated in this department or elsewhere, during the period Jan. 1998 to Dec. 2008. This study shows Plate failure more common than nail failure in long bone fracture of lower limb. In most of failure cases there was significant retrauma during the healing phase. In significant number of case there was inadequate post operative immobilization, in adequate fixation and poor surgical technique

Prevalence of sub-types and severity of red-green color vision deficiency in medical students of Karachi

The study aims to find out the prevalence of sub-types and severity of red-green color vision deficiency in medical students of Karachi. It was a cross sectional study conducted on the students of Karachi Medical and Dental College and Dow University of Health Sciences. With Convenient sampling, 550 healthy medical students [185 males and 365 females] were tested by using pseudo-isochromatic plates of 24-plates Ishihara chart. The data is presented in the form of numbers and percentages. 10 [5.4%] out of 185 males while only 01 [0.26%] out of 365 females were found to have red-green color vision deficiency. In males, 03 [1.62%] were Protans and 07 [3.78%] were Deutans. Protanomaly was detected in 01[0.54%], protanopia in 02 [1.08%], deuteranomaly in 02 [1.08%], deuteranopia in 05 [2.70%]. In females, the only case found was deuteranopia, 01 [0.26%]. By conducting screening for all medical students for diagnosing and detecting the sub-types and severity of CVD and provision of adaptive strategies and behavioral support will help them to deal with the potential difficulties, which could be overcome by awareness, self-training and effort. Moreover it is strictly advisable to avoid certain subspecialties as a career of choice

Phenyithiocarbamide taste sensitivity in a student population in Karachi

[PTC] among young adult population at Karachi. Student population of Karachi Medical and Dental College [KMDC], Karachi was included in this study. Total students consented to participate in the study were 258; 95 were males and 163 were females. They were asked to taste a drop of 0.5% solution of PTC, which was then spit out and mouth was rinsed with water. Out of 258 students, 41[15.89%] were found to be non-taster to PTC. Among 95 males, 19 [20%] were non-tasters and among 163 females, 22 [13.5%] were found non-taster to FTC. In young adult population of Karachi, 15.89% are non-taster to PTC. Males have 20% non-tasters and females have 13.5% non-tasters among them. Males have more non-tasters among them as compared with the females

Diabetic foot

To evaluate the precipitating causes, severity, and complications of diabetic foot. Material and This study carried out a study in Medical C Unit of Khyber Teaching Hospital, Peshawar. It was a longitudinal study done from June 2000 to December 2001. A total of 68 patients were studied having diabetic foot. Swabs for culture and sensitivity were taken. Other complications of Diabetes were recorded. Based on the observed commonest organism involved, appropriate antibiotic therapy was started promptly, besides doing surgical management of the wound. Out of 68 patients, 19 were Type-1 diabetic and 49 were Type- 2 diabetic. Forty patients [58.8%] were male and 28[[41.2%] were female. Thirty four patients [50%] had more than 11 years of duration of diabetes. Ill fitting shoes [19 patients] was the commonest precipitating cause. Three patients [15.8%] of Type-1 DM and 5[10.2%] of type-2 DM had grade 3 ulcer and 59[26.3%] and 6[12.2%] of Type-1 DM and Type-2 DM respectively had grade 4 foot ulcer. Staph. aureus was the commonest organism involved. Diabetic foot is still common and requires proper management and counseling of the patients

TIVA and conventional general anaesthesia in elective C-section: comparative effects on the neonate

A comparative study was carried out on 70 patients, admitted at MH Rawalpindi from January 2003 to April 2003. The object of the study was to compare the effects on the new born of TIVA [total intravenous anaesthesia] using IV Propofol and conventional general anaesthesia. The selection criteria included, pregnant patients of ASA class I aged between 20 and 30 years, undergoing elective caesarean section, having no fetal abnormalities on antenatal ultra sound and incision to delivery time less than 5 minutes. The apgar score of the new born delivered was measured at first minute and fifth minute after birth and it was seen that the average apgar score of the group delivered by TIVA using IV Propofol was 9.63 the other group delivered by using conventional general anesthesia was 7.94. However as the Apgar score is highly subjective, so it was supplemented by observing various neurobehavioral reflexes. This also proved that the newborn babies delivered by TIVA using IV Propofol had higher Neurobehavioral scores as compared to newborns delivered using conventional general anaesthesia

Preparation of Tc 99m-synthioglycolic acid-d1isoleucine [TC-99m-TGA-ILEU] complex and its comparison with T1 201-chloride for myocardial imaging

Dl-lsoleucine was complexed with Thioglycolic acid in the presence of Stannous ions to label with TC 99m-Pertechnetate. Percentage labeling was determined by paper chroma-tography.Preparations of more than 95% labeled with Tc99m were injected to rabbits for imaging and tissue distribution studies. Tc99m-TGA-ILEU complex was investigated as a myocardial imaging agent with respect to its kinetics and its percent