Risk factors in stroke

Stroke has remained a serious disease despite new post-stroke treatment strategies. This study was designed to identify risk factors for stroke. A hundred and one cases aged 18-87 years [60 male and 41 female] with first ever stroke where the lesion was confirmed by CT scan were studied prospectively. A detailed medical and family history was taken and general physical and neurological examination carried out according to the study protocol. Analysis of data showed that ischaemic stroke constituted 69.3% [n=70] of cases, intracerebral haemorrhage occurred in 27.7% [n=28] and subarachnoid haemorrhage was found in 2.97% [n=3] of cases. In both male and female groups the most likely stroke prone age was 50-70 years. Hypertension [56.4%], diabetes mellitus [27%], hyperlipidaemia [23%], I.H.D. [22%] and smoking [21%] were most commonly associated with increased risk for stroke. There was low frequency of cerebral haemorrhage in cases with diabetes mellitus and hyperlipidaemia as compared to cerebral infarction. Common risk factors in the present study were hypertension, diabetes mellitus, hyperlipidaemia, IHD and smoking

Multi-drug resistant typhoid in adults

A total of 100 clinically suspected cases of typhoid fever were studied during the period January 1993 to December 1994. Blood and bone marrow cultures were done to find out the pattern of anti-microbial sensitivity of Salmonella; 44 cases were culture positive. Salmonella typhi was isolated in 81.8% of the cases [n=36] while Salmonella para typhi A was isolated in 18.1% of the cases [n=8]. Salmonella paratyphi B and C were not isolated. All isolates of Salmonella typhi were resistant to conventional anti-typhoid drugs i.e. chloramphenicol, amoxycillin and co-trimoxazole, and were sensitive to aminoglyco-sides-gentamycin, third generation cephalosporin cefexim, cefotaxime, ceftazidime and ceftriaxone and to quinolones i.e. ofloxacin and glomefloxacin. All isolated of Salmonella paratyphi A were sensitive to conventional as well as the newer antibiotics mentioned above. It is concluded that, in view of the alarming increase in the incidence of multi-drug resistant salmonella typhi to conventional antibiotics, typhoid fever must be treated very cautiously, and newer antibiotics must only be used when they are indicated so as to prevent the development of microbial resistance against them

Acute poisoning: a review of 1900 cases

A review of nineteen hundred cases of acute poisoning admitted to the Intensive Care Unit shows that poisoning was responsible for 40% of the emergencies treated at this Unit, between 15th January, 1976 to 15th November, 1985. Comparing our data with Western figures, it was noted that the pattern of poisoning in our Country is considerably different from that in the West. Organophosphorus Insecticide Poisoning was by far the commonest in our series and was responsible for the majority of fatal cases. Over-all mortality rate for all the other poisons excluding Organophosphorus Insecticide compared favourably with Western figures, being 1.8%

Organophosphorus insecticide poisoning

A review of 755cases of Organophosphorus Insecticide Poisoning, admitted to the department of Intensive Care at the Jinnah Postgraduate Medical Centre between 15th January, 1976 to 31st December 1985, has shown that these insecticides form a majority of the cases of acute poisoning and are associated with a comparatively higher mortality rate. Of 1900 cases, 755 were cases of organophosphorus insecticide poisoning forming 39.7% of the total poisoning cases and 16% of the total admissions to the Unit. Being easily accessible, these insecticides are frequently used as suicidal agents specially by uneducated housewives. They are highly toxic and their management is very complicated. Of 108 deaths from poisoning in the last 10 years 73 [67.6%] were due to Organophosphorus Insecticide Poisoning. This being such a common mode of poisoning in our country, we have presented here our experience of the clinical features and management of these cases