ABSTRACT
Background and Objective: Both Hepatitis B virus [HBV] and hepatitis C virus [HCV] infections are rapidly spreading in the developing countries. Both of them are blood borne and are transmitted through un-screened blood transfusion, inadequately sterilized needles and equipment. According to WHO's criteria of endemicity, Pakistan has high disease burden of Hepatitis B and C. The present study was planned to determine the frequency and to identify the risk factors of hepatitis B and C virus in the general community of Farash town
Methods: This descriptive study was carried out in Al Nafees Medical Hospital Lab, from January 2013 to December 2013. Both the genders and all age groups were included in the study. All the patients who fulfilled the inclusion criteria had given a written consent. Data was collected through questionnaire and was analyzed on Statistical Package for Social Sciences [SPSS] version 21
Results: Three-hundred and forty five patients were studied. Among these 92 [27%] were males and 253[73%] were female, 33% of them had hepatitis C, 9% had hepatitis B. History of injections was reported in all of the patients. Visit to community barbers was present in 58.6% and 41% cases of hepatitis B and C. History of dental procedures was obtained in 7[24%] and 15[13%] patients of hepatitis B and C
Conclusion: Major contributors for Hepatitis B and C in Farash town are use of unsterilized therapeutic injections and visit to community barbers. Education of the barbers regarding sterilization may help in reducing the burden of infection in this community
Subject(s)
Humans , Female , Male , Adult , Middle Aged , Child , Child, Preschool , Infant , Infant, Newborn , Hepatitis C/epidemiology , Developing Countries , Risk Factors , Cross-Sectional Studies , Hepacivirus , Hepatitis B virusABSTRACT
Objectives: To assess the regional variation and clinical manifestations of acute dengue infection amongst the patients who presented to a tertiary care hospital of Rawalpindi
Study design: A Descriptive study
Place and duration: Study was carried out at Microbiology Department of Holy Family Hospital, Rawalpindi Medical College, Rawalpindi, from 1st August 2010 to 30th March 2011
Methodology: A simple random sampling technique was adopted for all the suspected cases of acute dengue, admitted in the dengue ward of Holy Family Hospital, Rawalpindi. Their blood samples were taken and analyzed by ELISA test for the detection of antidengue antibodies [IgM]
Results: A total of 30.2% [n=104] patients were diagnosed positive by ELISA test. The frequency of dengue fever [DF] in males was 68.2% [n=71] and in females it was 31.7% [n=33]. The incidence of dengue fever was high in Rawalpindi [30.2%] and Chakwaal [30.1%]. The most common clinical manifestations were high grade continuous fever [>10[degree]F] seen in 88.4% [n=92], followed by retro-orbital headache 65.3% [n=68], epigastric pain 65.3% [n=68], arthralgias 63.4% [n=66] and myalgias 50% [n=52]
Conclusion: The incidence of Dengue fever is high in Rawalpindi and Chakwaal. The most common clinical manifestations of acute DF include high grade continuous fever along with retro-orbital headache, epigastric pain, myalgias and arthralgias
ABSTRACT
Objective: The objectives of current study were to find out the prevalence of Dengue viral infection [DVI] IgG amongst the adult population residing in urban/ rural areas of Rawalpindi in order to assess that in which specific population it is more prevalent. The hypothesis of the study was that DVI is more prevalent in urban areas of Rawalpindi district
Study Design: Descriptive Cross Sectional Comparative Study
Place And Duration: It was carried out at Microbiology Department of Benazir Bhutto Hospital Affiliated with Rawalpindi Medical College, Rawalpindi. It was carried out from March to September 2010
Methodology: Stratified random sampling procedure was adopted for 240 healthy adults, 144 urban residents and 96 rural residents of Rawalpindi. The clotted blood samples were used for the detection of anti-dengue Ab [IgG] by 3[rd] generation ELISAmethod
Results: The results were in favor of the hypothesis showing 34.7 % prevalence of DF in urban areas when compared to 19.7% prevalence in rural areas of Rawalpindi
Conclusion: Dengue fever is more prevalent in urban areas of Rawalpindi
ABSTRACT
Rubella is a highly contagious viral disease, spread through contact with discharges from the nose and throat of an infected person. For women who are not immune, rubella infection during pregnancy poses a high risk of congenital birth defects and miscarriages or stillbirths. Researches show that infection during the first trimester carries an 85% risk of birth defects. We present a case report of a woman who suffered from rubella during her first trimester of pregnancy with a history of repeated miscarriages
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The global burden of tuberculosis has increased a lot due to the emergence of multidrug-resistant TB [MDR-TB] and extremely drug-resistant TB [XDR-TB] cases. The current situation necessitates the need of aggressive therapy for longer duration. The use of aminoglycosides and polypeptide antibiotics as category l and ll regimen have shown significant positive outcome for the management. Besides the beneficial effects, these drugs harbors serious side effects like the permanent hearing loss and the reversible renal damage. Therefore, there is a dire need of including serial audiometries amongst protocols for the patients being managed by aminoglycosides in order to minimize the emergence of permanent hearing loss
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Objectives: To find the role of Problem Based Learning [PBL] as a learning strategy in the integrated undergraduate curriculum of a medical college and to determine as to what extent it should replace the conventional lecture system
Study Design: A descriptive cross sectional study
Place And Duration: It was a descriptive cross sectional study carried out at Shifa College of Medicine, Islamabad from January to June 2009
Methodology: The study included a total of 141 students [both male and female]. Out of these 96 were from 3[rd] year and 45 from 4[th] year MBBS classes. They were informed about the study design. Since the system was newly introduced to the students, a simple questionnaire was distributed only to know the students' perspective to this new way of learning. The questionnaire contained only a few basic questions regarding their understanding of the PBL; whether it was better than the lecture system, pros and cons; whether it should wholly replace the previous system or a part of the whole curriculum be devoted to the new system
Results: Out of 96 3rd year students 67% [n=65] voted for a combination system, while nearly half 48% [n=22] favoured almost a complete shift to the PBL system. Over all, out of the total 141 students, 62% [n=88] preferred a rational combination of the formal lectures and PBL in small groups, while 38% [n=53] were in favour of only [PBL] as a learning strategy. There was a difference in response depending upon the level of the students
Conclusion: PBL has a substantial role as a learning strategy in the undergraduate medical curriculum. The extent to which it should forma part of the whole teaching strategy will depend upon the level and the preference of the students
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The source of Naegleria fowleri [N. fowleri] Infection is via direct contact with poorly chlorinated or contaminated water. It can easily be acquired during swimming or face wash with contaminated water through inhalation of Naegleria cysts. The mortality rate with N. fowleri or 'brain-eating amoeba1 has been estimated to be as high as 98%
The exact prevalence of N. fowleri infection in Pakistan cannot be assessed because of limited National data. The clinical manifestations usually mimic meningitis and hydrocephalous, thus, remained the main reason for under reporting of these cases
Therefore, there is a dire need to adopt proper diagnostic approaches through cerebrospinal fluid [CSF] microscopic examination and molecular detection by polymerization chain reaction [PCR] studies in all the suspected cases. Moreover an aggressive combination therapy with Amphotericin B, rifampicin and miconazole can be helpful to reduce the high mortality rate form the said infection
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Objectives: The objective of this study was to identify the association between cigarette smoking and serum bilirubin antioxidant concentrations
Study Design: A descriptive cross sectional study
Place And Duration: Study was conducted at the Department of Biochemistry at Sheikh Zayed hospital Lahore over a period of one year from January 2012 to December 2012
Methodology: The sample size was sixty with an equal distribution of healthy and control group. Thirty were known smokers and thirty were healthy controls. Thirty smokers who had been smoking for at least five pack years [20 cigarettes per day for one year is equal to one pack year] were included after ruling out coronary artery disease by Exercise Tolerance Test. Same no. of healthy control subjects were selected from general population with no history of smoking, CAD, Diabetes and hypertension
Results:The results of the study have shown that smoking decreases the serum bilirubin concentrations. The mean value of serum bilirubin in 50%[n=30] smokers was 0.59 + 0.034. While in control group 50%[n=30], it was 0.85 + 0.057
Conclusion: From the results, it was concluded that cigarette smoking lowers the bilirubin antioxidant concentration
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Objective: The objective of the current study was to establish the reference ranges of haematological indices amongst five healthy infantile [< 1 year] age groups
Methodology: It was a descriptive cross sectional study carried out at the Department of Haematology, Armed Forces Institute of Pathology [AFIP], Rawalpindi. Non probability convenience sampling was adopted for the proceedings for the study. A sample size was 2000 which was equally distributed as 400 samples for all the five age groups i.e. < 27 days, 3 month, 6 month, 9 month and one year. One thousands were males and 1000 were the females. An informed consent from the guardian was the pre requisite of study, while those candidates having an evidence of any systemic illness were not excluded
Results: The values of haematological indices i.e. MCV, MCHC, MCH, PCV and RDW varies with growing age of an infant. A decrease in all these values was observed from < 27days to one year of age infants
Conclusion: A decrease in all these values was observed from < 27days to one year of age infants. The values reported in this study can be used as a local reference for the newborn aged between <27 days and 1 year of age
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Objectives: To verify that the H. pylori infection predisposes to acid peptic disorders, and also find out the importance of non-invasive diagnostic approach. Moreover, to judge the need of quadruple therapy i.e. Amoxicillin, Metronidazole, Clarithromycin, and a proton pump inhibitor along with an appropriate duration in order to reduce the emergence of antibiotic resistance
Methodology: It was a Descriptive study. The data were collected through electronic means from the National and internationally published data by simple random sampling technique. The latest reports published by World Health Organization, Centre for Disease Control were considered for reference. The original and review articles published in different National and International Journals and available online on Pubmed and Medscape were also taken for reference. While some aspects were also searched from other medical related websites and Google. The Selection criteria for this meta-analysis were the data related to positive cases of H. pylori in patients having acid peptic disorders especially diagnosed through serological identification and were managed through quadruple therapy or by three drugs. The Quality criteria for the reference data was made sure through the authenticity of researches and reports published from recognized and indexed medical websites
Results: This Meta-analysis has shown that H.pylori is the leading cause of various acid peptic disorders. The adoption of non-invasive diagnostic approach should be the preferred one, proven to have the sensitivity and specificity of about 98.3% and 95.0% respectively. Moreover a quadruple therapy i.e Amoxicillin, Clarithromycin, Metronidazole, and a Proton pump inhibitor given for at least 7 to 10 days, has proven to be the best management strategies
Conclusion: There is a dire need to early/accurately diagnose the infection and adoption of quadruple therapy regimen in order to minimize the emergence of drug resistant cases
ABSTRACT
To study the efficacy, desirable and undesirable effects of locally injectable preparation of botulinum toxin in patients suffering from Benign Essential Blepharospasm [BEB]. It was a prospective study carried out from October 2006 till November 2012 at a private set up, [Dr Shakaib's Eye Clinic], in Islamabad. Follow up of Seventeen patients of BEB has been done over six years period after injecting botulinum toxin. The patients had been explained about the study and informed consent was taken. After taking all the standard precautions for botulinum toxin injection, 5 to 7 [mean 6] sites for injecting 1.5 to 2.0 IU of the toxin were selected depending upon the severity and duration of the problem. These patients were requested to attend the clinic regularly, initially after three days and then weekly for two weeks, followed by every month for three months and then at three monthly intervals for up to six years. The useful effects of the injection appeared in all the patients within 48 hours. There were minor side effects like irritation in the eyes and heaviness in the brow region. One [5.88%] patient developed mild ptosis, which subsided over two weeks. Four [23.52%] patients felt almost cured after three to four repetitions of injections. The useful effect of the injection lasted for about three months in all the patients. Botulinum toxin is a useful remedy for Benign Essential Blepharospasm [BEB], although the effects are short term and repeated applications are required which is quite costly for the patient
ABSTRACT
AIMS AND OBJECTIVES: To highlight one of the presentation of primary Dengue Viral Infection [DVI] as Pyrexia of Unknown Origin [PUO] in less than 18 years of age group
MATERIALS AND METHODS: It was a Descriptive cross sectional study carried out in the Department of Microbiology, Rawalpindi Medical College and Allied Teaching Hospitals, Rawalpindi. A Simple Random Sampling procedure was adopted to collect the samples from Pediatric and Medicine Departments of RMC and Allied Teaching Hospitals, RWP. The sample size was 117 Samples based upon inclusion and exclusion criteria of study. The data was recorded on the bio data proformas and finally analyzed by SPSS version 16
The frequency of positive cases was calculated in terms of percentages. 3 Generation ELISA was used to assess the presence of anti- Dengue IgG antibodies
RESULTS: Out of total 117 PUO patients, 41 [35%] were found positive for IgG DEN 2 antibodies
CONCLUSION: Dengue viral infection can present as PUO. The results of this study will be helpful for the clinicians to consider DVI in their list of differential diagnosis of PUO
ABSTRACT
AIMS AND OBJECTIVES: To highlight the importance of bone marrow examination in order to assess different causes of fever especially pyrexia of unknown origin
STUDY DESIGN: It was a Descriptive cross sectional study
PLACE OF STUDY: The study was conducted at Haematology Department of Benazir Bhutto Hospital, Rawalpindi
PATIENTS AND METHODS: The retrospective information was gathered from the record saved in the official departmental registers. The data from June 2005 to June 2010 was included in the study. Both the males and females having the history of fever were included in the study. Data analysis was done by SPSS version 16.The frequency of occurrence of specific diseases was calculated in terms of percentages, while the mean values were calculated for ages and duration of illness
RESULTS: Chronic disorders [20.1%], followed by myelofibrosis [7.6%], and metastatic infiltrations [6.5%] are amongst the most common causes of PUO. Chronic disorders [33.12%] followed by mixed deficiency anaemia [15.95%] and megaloblastic anaemia [11.65%] were amongst the common causes of high grade fever. While chronic disorders [35.8%] followed by mixed deficiency anaemia [16.21%] were the common causes of low grade fever. The intermittent pattern of fever was found to be associated with underlying chronic disorders [28.26%] followed by mixed deficiency anaemia [13.86%]
CONCLUSION: Bone marrow examination should be considered in the early course of illness especially when other laboratory studies yielding the negative results