Evaluation of efficacy of intravenous magnesium sulphate versus dexamethasone for prevention of postoperative sore throat in patients undergoing lumbar spine surgery in prone position: a prospective randomized double blind placebo controlled study

Background: Endotracheal intubation is associated with postoperative sore throat. The aim was to evaluate the efficacy of intravenous magnesium sulphate versus dexamethasone for prevention of postoperative sore throat in patients undergoing lumbar surgery in prone position.Methods: 150 patients of ASA physical status I and II in the age group of 18 to 70 years were divided into three groups of 50 each. group I (magnesium sulphate) received intravenous magnesium sulphate 30 mg. kg-1 in a total of 50 ml of normal saline for 10 minutes after intubation, group II (dexamethasone group) received intravenous dexamethasone 8 mg in 50 mL normal saline for 10 minutes after intubation and group III (placebo group) received 50 ml of normal saline for 10 minutes after intubation. The incidence and severity of postoperative sore throat and hoarseness was assessed by an anesthesiologist unaware of the group allocation, on arrival in the post anesthesia care unit at 0 h, and at 1 h, 6 h, 12 h, and 24 h thereafter.Results: Both incidence and severity of sore throat and incidence of hoarseness was more in placebo group than magnesium sulphate group and dexamethasone group and was statistically significant (p<0.05) and was comparable between magnesium sulphate and dexamethasone groups.Conclusions: Endotracheal intubation is associated with sore throat and hoarseness of voice. Magnesium sulphate and dexamethasone given intravenously reduce the incidence and severity of sore throat and hoarseness associated with endotracheal intubation.

Ruptured infected femoral pseudoaneurysm in iv drug abusers ligation under local anesthesia

Background: IV drug abusers usually present with life threatening hemorrhage from ruptured infected femoral pseudoaneurysm in emergency. Back up of family, friends and resources are marginal with these patients. In literature many procedures from simple debridement to extra anatomic bypass have been reported

Objective: To assess the outcome of ligation of external iliac artery under local anesthesia in terms of survival, limb salvage and feasibility

Methodology: This cross sectional study was conducted in Department of Surgery, Quaid e Azam Medical College, Bahawalpur. Duration of study was five years from 1st December 2010 to 31st December 2015. All patients presenting with bleeding or ruptured femoral pseudoaneurysm in this time span were admitted. Pressure dressing over bleeding aneurysm was done; wide bore peripheral IV line/CV line was passed; fluid resuscitation was started; broad spectrum antibiotics were injected; request for blood arrangement sent and necessary investigations were sent; special consent was taken. Local Anesthesia was injected in the groin just above the aneurysm ketamine given their needed. External iliac artery was explored in supra inguinal position and ligated. Data regarding age, gender, drug of abuse, vascular status of the limb, need for blood transfusion during procedure, life safety, limb salvage was analyzed. Data was entered and analyzed by using SPSS version 20

Results: We ligated external iliac artery just proximal to aneurysm in 48 patients under local anesthesia. Life and limb was saved in 43 [89.5%] patients. Five patients [10.5%] required above knee amputation later

Conclusion: Ligation of external iliac artery under local anesthesia in ruptured pseudo aneurysms is simple and safe

Two years' study of Tetanus cases in a paediatric intensive care unit

Objective: To study the demographic and clinical features, outcome, complications and treatment cost of tetanus patients admitted in Paediatirc Intensive Care Unit [PICU] of Civil Hospital Karachi [CHK]

Methods: It is a descriptive observational study conducted at Civil Hospital Karachi from July 2013 to June 2015. Patients of tetanus admitted in PICU during the study period were enrolled. Data was collected from the file records of patients and included the demographic profile, clinical presentation, grade of severity, length of stay, complications and outcome. It also included the cost of treatment. Descriptive statistics were applied to describe the results

Results: During the study period, 23 cases of tetanus were admitted in P.I.C.U. twelve were male and 11 female. Majority of cases [13] belonged to age group 2-6 years. Seventeen cases were unvaccinated and 6 had received only BCG and OPV. None was appropriately vaccinated for age.There were 9 cases of post injury tetanus, 6 of them were males, 5 cases of otogenic tetanus and 9 cases had no clinically identifiable portal of entry. Eleven cases belonged to grade III severity of Ablett classification and 6 had grade IV severity. Mortality in our case series was 26%. Autonomic instability was seen in 17 patients and all of them needed ionotropic support. The estimated cost of per day treatment of a tetanus patient with mechanical ventilation was approximatly 31, 979/Pak Rs and without mechanical ventilation was 20,000/Pak Rs

Conclusion: Tetanus is an entirely preventable disease with a high mortality. Treatment is very costly as compared to vaccination which is free of cost. Complete vaccination and proper wound care is the only option to reduce the ongoing burden of tetanus

Lumbar interlaminar epidural injections in managing chronic low back pain with sciatica without using fluoroscopy

Objective: to find out the effectiveness of interlaminar parasagittal lumbar epidural injection without using flouroscopy in the management of low back pain with radiculopathy

Study design: descriptive case series

Place and Duration of study: Ziauddin University Hospital Karachi Clifton campus, from January 2013 to December 2014

Methodology: patients with lumbar back pain associated with unilateral sciatica for more than three months duration were included. Visual analogue scale [VAS] of 100 was used for pain severity assessment. Lumbosacral spine x-rays with skin surface marking were obtained before the procedure. Interlaminar parasagittal approach was used in lateral position with affected leg up. Follow up was done at 6 weeks, 3 months, and 6 months. During the course of 6 months, three injections were offered at any point of recurrence of pain with at least 2 to 3 weeks interval

Results: a total of 75 patients of both genders with the mean age of 45.03 +/- 14.35 year were included. Disc levels involved were L4/5 [53.33%], L5/S1 [38.66%], and L3/4 [8%]. Pre-procedural mean VAS score was 75.2 +/-15.99. In 65.33% patients sustained significant relief in pain noted at six months follow up. In 20% patients short term recovery observed with recurrence of pain in three months. No major complication was encountered during the procedure

Conclusion: interlaminar parasagittal epidural injection is simple, effective in relieving chronic low back pain associated with sciatica and does not need any special medical equipments and setup

Job satisfaction of physicians and teachers; regular verses contract basis jobs

Objectives: To determine the level of job satisfaction of physicians and teachers having regular jobs and those having contract based jobs and to compare level of job satisfaction between these types of jobs and between the two professions

Study design: Cross sectional study

Duration and place of study: This study was conducted with teachers and physicians recruited at different schools, colleges and hospitals of Faisalabad in six months from October, 2008 to March 2009

Subjects and methods: A sample of 200 participants, 100 physicians [50 regular and 50 on contract basis] from public hospitals and 100 teachers [50 regular and 50 on contract] from public schools and colleges was drawn through purposive convenient sampling technique

Result: In overall profession wise analysis teachers scored higher on job satisfaction scale [m=131.98] than physicians [m=126.98]. Personals having regular jobs had lower job satisfaction [m=128.52] than professionals have contract jobs [m=130.45]

Conclusion: Contract based jobs carry higher levels of job satisfaction for employees than the regular based jobs

Frequency of HBV, HCV andmalaria infections in cytopenic patients coming for bone marrow aspiration to bacha khan medical college mardan

Objective: To know the frequency of HCV, HBV, and Malaria infections in cytopenic patients coming for Bone Marrow Aspiration

Study Duration: Observational study

Place and Duration of Study: This study was conducted in Pathology and Medicine Departments of Bacha Khan Medical College Mardan from January 2012 to December 2014

Materials and Methods: 100 patients with cytopenia were referred for Bone Marrow Aspiration and were screened for HBV, HCV and malaria infections. Complete blood counts were performed on 50 healthy individual as a control group.Both Thick and Thin Blood smears were examined for Malaria, while Anti HCV and HBs Ag Screening was done by kit method [Immunochromatographic Method SD company]. Complete blood count was performed by Heamatologyanalyser. [Sysmex Hematology Analyzer ]

Results: 4 out of 100 cytopenic patients were Anti HCV positive, who were referred for Bone Marrow Aspiration. These patients had a Hemoglobin level 10.5 +/- 0.978 G/dl, Platelets counts 120 +/- 24.768×103/uL. 2 out of 100 Cytopenic patients were HBs Ag Positive. They had anemia and thrombocytopenia, Hb level was 10.4 +/- 0.879 g/dland platelets count was 119 +/- 24.965×103/uL respectively. while 7 [7%] out of 100 cytopenic patients had malaria microscopy.TheypresentedwithHbof9.5 +/- 0.978g/dl,plateletcount120 +/- 24.768×103/uLandTLC3.8 +/- 1.365×103/uL respectively. Counts in HCV, HBV and malaria are significantly lower than the control groups value < 0.0024

Conclusion: Cytopenia is a significant finding in HCV, HBV and Malaria infections and patients presenting with any cytopenia patients referred for Bone marrow Aspiration presenting with cytopenia should be properly screened for HCV, HBV, and Malaria as these can be the cause of cytopenia thus unnecessary use of Bone Marrow Aspiration can be presented

Association of HIV with drug dependence; socio-demographic characteristics of substance abusers inclusive of HIV positive admitted in model drug abuse and treatment center, DHQ hospital, Faisalabad, Pakistan

This study was undertaken with an objective of collecting basic data to assess the extent and variety of drug abuse in patients presenting to the model drug abuse and treatment center, DHQ hospital, Fsd as per social and demographic circumstances. cross sectional study. The study was conducted in the indoor Department of Model Drug Abuse Treatment Center of Department of Psychiatry and Behavioral Sciences, DHQ Hospital, Faisalabad from Jan-2014 to March-2014. 80 patients dependent on different drugs participated in this study through purposive convenient sampling technique. Personal, Social, and Demographic variables were recorded on a demographic sheet. The results were obtained by using SPSS 17. Descriptive statistics showed that 31 patients [38.8%] were HIV positive. Most of the patients were males [97.5 %], between 30 to 35 years of age [28.8%], married [61.3%], lived in urban areas [55%], illiterate [32.5%], had primary level education [21.3%], or middle level education [22.5%]. 51.3 % patients were laborers. As illiteracy, low education, unemployment, labor as profession, and peer pressure are the key features of drug abusers. So, parents, health professionals, and state personals should take these as risk factors and focus upon these population segments to spread awareness and take measures of control to minimize the incidence of substance abuse

Evaluation of knowledge attitude and practice of health care staff on biosafety and biohazards, district Pakpattan Punjab

To evaluate the knowledge, attitude and practice of health care staff on bio-safety and biohazards in District Pakpattan. Cross Sectional epidemiological Study. This study was conducted in District Pakpattan Punjab, Pakistan from 1[st] August 2013 to 30[th] August 2013. The study was carried out to evaluate the knowledge attitude and practice on bio-safety and biohazards of health care providers, who are directly involved in the patient handling e.g. doctors, lady doctor, laboratory and blood bank technicians, Nurses, Dispensers, Lady Health Visitors, Vaccinators, OT Assistants, dental technicians, dental surgeons, while others were excluded. The target population was 552, and 33% [N=184] population was included in the study as non probability sample to reduce the bias in this reference epidemiological study. A standard questioner was pretested to identify weaknesses and strengths. Respondents interviewed individually and data was analyzed by using SPSS.15.0 for Widows Evaluation Version. Keeping Ethical Consideration in view, formal consent and permission was obtained from concerned Authorities and respondents. The study results on the variables were as; 27[14.6%] had specific training on bio-safety and biohazards,157[85.3%] had no structured training. 96[52%] respondents had habit of eating at work place, laboratory, dressing or examination rooms, 83[45%] don't have this habits or practice while 6 [3.2%] do this practice sometimes. 98[53%] had habits of storing edibles in the refrigerators meant for vaccines or laboratory purpose, 84[45.6%] don't have this habits and 2[1.0%] do this practice sometimes. Among females[N91], 35[38.4%]using cosmetics at work place,42[46%] don't have this habits or practice,11[12%] do this practice sometimes. Out of 161 the 62[40%] had habits of smoking or sniffing at work place, 99[60%] don't have this habits or practice. 89[48.3%] had habits of cutting nail with teeth and putting pen in the mouth at work, rest 93[50%] don't have this habits or practice. The study results are consistent and supported by many studies already conducted. Results showing poor knowledge, attitude and poor practices. It demonstrates the serious need of trainings on bio-safety and continuous monitoring on the practices to minimize the health risk, which is a hidden public health problem

Personality traits of the adjusted and maladjusted medical students in punjab medical college, Faisalabad, Pakistan

Objective: The study was designed to examine the association between the personality traits and adjustment level of medical students

Method: 190 medical students from Punjab Medical College, Faisalabad participated in this study through purposive convenient sampling technique. Personality traits were measured through Gordon Personal Inventory [GPI] and Gordon Personal Profile [GPP], while adjustment and mal adjustment was assessed through Rotter's Incomplete Sentences Blanks [RISB]. The results were obtained through chi square statistics on SPSS version 17

Results: Results showed that out of 190 medical students 173 students [91%] were well adjusted. While 17 students [9%] obtained RISB scores above the cutoff point hence they were labeled as mal adjusted. Hypothesis testing with Chi square test has shown statistically significant differences in the scores on the trait of responsibility, cautiousness, personal relationship and vigor among adjusted and mal adjusted medical students. Mal adjusted students were seen associated with below average scores on all previously mentioned traits

Conclusion: The traits of responsibility, cautiousness, personal relationship and vigor are crucial for the adjustment in the society. So the parents and teachers should play their part in improving the fabric of the society by the means of building and emphasizing upon the sense of responsibility, cautious behavior, balance in personal relationships, and vigor in daily tasks among their children and students so that they may become well-adjusted in the society

Socio demographics of drug dependents

Objective: The study was designed to examine the split up of social and demographic variables of drug dependent patients approaching the hospital for treatment so that the risk factors may be determined

Study design: cross sectional study

Place and duration of study: The study was conducted indoor patients Drug Abuse Treatment Center of Department of Psychiatry and Behavioral Sciences, DHQ Hospital, Faisalabad from Jan-2007 to July-2008

Method: 588 patients dependent on different drugs participated in this study through purposive convenient sampling technique. Personal, Social, and Demographic variables were recorded on a demographic sheet. The results were obtained by using SPSS 17

Results: Descriptive statistics show that out of 588, 584 patients [99.2%] were males, 64.8% were between 20 to 35 years of age. 360 [61.1%] were married, while 451 [76.6%] lived in their own houses. 374 patients [83.7%] belonged to the lower or lower middle socio economic status, 242 patients [41.1%] were illiterate, 125 patients [21.2%] had primary level education, and 102 [17.3%] had middle level education. 283 [48.1%] patients were laborers [half were skilled] while 100 patients [17%] were unemployed. 410 patients [69.6%] used heroin, 259 [44%] used cannabis, while 162 [27.5%] patients were poly drug abusers. 430 [74%] patients told peer pressures to be the reason of first drug abuse

Conclusion: As illiteracy, low education, unemployment, labor as profession, and peer pressure are the key features of drug abusers so parents, health professionals, and policy makers should take these as risk factors and focus upon these population segments to spread awareness and take measures of control

Gender differences in test anxiety and examination stress

To assess and compare the level of test anxiety and examination stress among males and females university students. Cross sectional study. The study was conducted in the Department of Sociology and Business Administration, University of The Punjab, New campus, Lahore from June to August 2005. 100 students of sociology and business administration [50 male, 50 female] were approached 3 to 7 days before their final exams through purposive convenient sampling technique. Female students experience significantly higher level of test anxiety, t [98] = 3.83, p < 0.05, Worry, t [98] = 2.458, p < 0.05, Emotionality, t [98] = 4.47, p < 0.05 and Examination stress, t [98] = 2.01, p < 0.05 as compared to male students. In addition, female students reported a significantly higher level of need for family support as compared to male students, t [98] = -3.623, p < 0.05. Female Masters' students are needed to pay more attention on controlling their level of test anxiety, worry, emotionality and examination stress than male students, which could be done through training them. Bearing in mind the gender differences in test anxiety and examination stress different kinds of counseling strategies must be used for males and females

Diaphragmatic crural splitting and median arch formation variations

Objective: This study was designed to note downvariations in the way of attachment of the crura ofthoraco abdominal diaphragm and the way theyform the median arch in view of their role as abarrier in gastro esophageal reflux and in designingesophageal hiatus

The Study Methodology: Itwas carried out in the anatomy department ofPunjab medical college Faisalabad during yearsfrom 2006 to 2010. A total number of 45 humancadavers were dissected for this study. The observedvariations were recorded and analysed

Results andConclusion: The crura at their vertebral attachmentseen divided into slips both on right and left sides in64.4% of the cases. In the remaining 35.6% of thecases they did not show this division on either side.Two slips were noted in 48.9% of cases on rightside and in 60% of cases on the left side. The medialmost slips of both sides joined each other to formmedian arch in 88.9% of cases. In 22.2% of casesthe arch formed at level between 1st and 2nd lumbarvertebra. Identification of these anatomicalvariations would be helpful in understanding thebases and treatment of gastroesophageal refluxdisease and hiatal hernia etc

relationship between the characteristics of mentallyretarded persons and the quality of life perception oftheir parents

Objective: The study was designed to assess thelevel of quality of life [QOL] in the parents ofindividuals with mental retardation [MR] and itsrelationship with the characteristics of the sufferingindividuals

Study Design: Quasi experimentalresearch design

Place: The study was carried out inthe Department of Psychiatry and BehavioralSciences, Allied/DHQ Hospitals, PMC Faisalabad,Almasoom center Faisalabad and Amine Maktabspecial institute for mentally retarded childrenLahore

Duration of the study: The study wasconducted during July 2007 to December 2007

Method: 98 mothers and 91 fathers of mentallyretarded individuals from public Hospitals andcenters for mentally retarded children in Faisalabadand Lahore participated in this study throughpurposive convenient sampling technique. Qualityof life was measured by WHO QOL-BREF[Validated Urdu Version] while demographicvariables were recorded on a demographic sheet.The results were obtained by using analysis ofvariance [ANOVA] on SPSS 13

Results: Mothershad scored higher on QOL environment domainwhen their MR Child had the ability to dojudgments in daily living, F [1, 97] = 4.640, p < .05.Fathers of the MR persons who can reason havescored higher on this domain [M = 16.105] than thefathers of the MR persons who can not reason [M =13.694], F [1, 90] = 6.692, p < .05. ANOVA showeddifferences in the QOL scores of the fathers onpsychological, F [1, 90] = 4.819, p < .05, socialrelationships, F [1, 90] = 5.174, p < .05 andenvironment domain, F [1, 90] = 5.320, p < .05depending upon the ability of MR person to travelpublic transport; independent sample t test producedenough evidence to establish the effects on all fourdomains of QOL

Conclusion: In the face of theevidence of high deterioration in quality of life ofthe parents in absence of judgments to daily living,reasoning, and ability to travel public transport, it isto be communicated to parents and teachers of MRpersons to pay more attention on the training ofthese skills. Further more physicians, psychiatrists,other health care professionals and members of thefamily are to be sensitized in identifying thisdisturbance in the quality of life perception in orderto take measures against it so that familyfunctioning may not be disturbed

Prevalence of depression among tuberculosis patients

Objectives: To find out frequency of depression among Tuberculosis [TB] patients, to study the causes of depression in them and its effect on treatment and prognosis of T.B

Study Design: Cross-Sectional Study

Study Area: Department of Chest Medicine District Head Quarters and Red Crescent T.B Hospital, Faisalabad

Duration of Study: March - May 2009. Study Population: TB patients admitted in Department of Chest Medicine DHQ and Red Crescent T.B Hospital, Faisalabad

Sample Size: Sample size was 60 TB patients

Sampling Technique: Convenience sampling technique

Data Collection Tool: Beck's Depression Inventory-II[BDI-II in Urdu] semistructured questionnaire was used for data collection for all TB patients who were able to understand it. Diagnosis was made as per Diagnostic and Statistical Manual of Mental Disorders, Fourth edition [DSM-IV]

Results: Depression was present in about 80% of the hospitalized TB patient. It was more common in males about 86%, while in the females it was about 71%. According to age, young and elderly patients were found to be more affected. Majority of the TB patients had moderate depression, while some had severe and mild depression. Main causes of depression among the male TB patients 24.7% were due to altered social relationship and among female TB patients 23.33% were due to TB stigma

Conclusion: It is concluded from this study that 80% patients were suffering from depression. The frequency of depression was found to be 86% among males; while 71% of the female patients were found to be depressed. Main causes of depression among the male TB patients were altered social relationship and among female patients TB stigma. Depression had adverse effect on drug compliance and TB treatment

Self esteem and psychosocial factors associated with juvenile delinquency

Objectives: The study was designed to assess the level of self Esteem of juvenile delinquents and to find the psychosocial factors associated with delinquency

Study Design: Cross sectional study

Duration and Place of Study: This study was conducted in Borstal jail of Faisalabad, Pakistan during a period of three months from February, 2008 to April, 2008

Subjects and Methods: A sample of 100 male juvenile delinquents was drawn from Borstal jail Faisalabad through Purposive Convenient Sampling technique. Data were collected from participants by using informed consent with the permission of the jail authorities

Result: In the over all picture of the data 56 [56%] of the total sample reported low self esteem. Mean of delinquents labeled as having low self esteem could only reach 13.46 on Rosenberg self esteem scale. High frequency of delinquent behavior was related to feeling of revenge with the mean of 6.00 and high frequency was also associated with love affairs with the mean of 2.80 in delinquents with low self esteem

Conclusion: Research findings concluded that low self-esteem, revenge and lack of supportive relationships are associated with delinquency

Dermatological disorders; psychiatric co-morbidity

The study aimed to determine the prevalence and risk factors of Depression and Anxiety in indoor Patients of Dermatology Department. cross sectional study. The study was conducted at in door Department of Dermatology, D.H.Q Hospital Faisalabad from August 2006 to October 2006. A total of 77 diagnosed dermatological patients, [21 males and 56 females] were selected by using non-probability convenient sampling. Hospital Anxiety and Depression Scale and DSM -IV-TR criteria for depression and anxiety were used to evaluate the patients. QOL-BREF was administered. Results were also correlated with patient's demographics. Out of 77 Patients who were enrolled in a study, 52% of subjects reported psychiatric co-morbidity regarding anxiety and depression according to DSM-IV-TR, HADS, anxiety and depression score was 12.75 [ +/- 4.33] and 11.18 [ +/- 4.51] respectively. A strong co-relation of HADS anxiety and HADS depression was found with the DSM-IV- TR diagnosis respectively. The strong negative association was found with the education, monthly income and socio-economic status respectively. The study shows high Prevalence of Depression and Anxiety in Patients having dermatological disorder. The findings also highlight the importance of recognizing dermatological disease related psychiatric problems. Through training, dermatologists can identify psychiatry morbidity and play their role in early detection, management and referrals of complicated cases of these co- morbid conditions. In this way better quality of care can be assured

Depression and drug non- adherence

To determine the different levels of drug non-adherence in patients suffering from Depression. A case-controlled study. Hayatabad Medical Complex Peshawar, From February 2008 to August 2008. 50-Cases were selected from the out patient department with the DSM-IV diagnosis of major depressive disorder, 50- non psychotic patients were selected as controls. Both sexes were included. The basic socio-demographic characteristics and the clinical profile of all the patients were collected. The level of drug non-adherence was recorded at week 4, week 8 and week 12. SPSS version 15 was used for statistical analysis. The applied method for group comparison was the Chi-square test. The age in mean was 33.78 +/- .30 for the sample and 30.65 +/- 40 for control group. 38% of these patients were males and 62% females. 58% were married and uneducated from lower socio-economical class. 70% of the study group and 59% of control group received treatment. The rates of non adherence were statistically not significant at week 4. However, at week 8 and week 12 the rates of non adherence were statistically significant with the p values of less than [0.001] respectively. Rates of non-adherence with psychotropic / antidepressants are difficult to summarize because they vary with setting, diagnosis, severity of illness and type of adherence difficulties. Drug non-adherence is a serious clinical problem and it has direct effects on illness management and prognosis. The available evidence suggests that the outcome for patients who vary medication doses without consulting a professional is poor

Psychiatric co morbidity in medical patients

To assess the rate of anxiety and depression in the patients suffering from various medical diseases. Cross sectional study. The study was conducted in District Headquarter Hospital and Allied Hospital, Faisalabad from 2005 to 2007. Participants were inducted in the study through purposive convenient sampling technique, 339 patients of cardiac, cancer, hepatic, and dermatological diseases from both the above mentioned hospitals participated in this study. Co morbidity of psychiatric disorders was screened out with the help of DSM IV TR's criteria for depression and generalized anxiety. Anxiety [n=32, 9.43%] was the major diagnosis in age group 40-49 and depression [n=31, 9.14%] in age group 50-59. All the diagnosis i.e., anxiety [n=30, 8.84%], depression [n=51, 15.04%] and both anxiety and depression [n=25, 7.37%] were common in illiterate patients. Anxiety [n=37, 10.91%] and depression [n=57, 16.81%] was found more in housewives. All the diagnosis i.e., anxiety [n=77, 22.71%], depression [n=93, 27.43%] and both anxiety and depression [n=45, 13.27%] were common in married patients. Anxiety [n=54, 15.92%] was common in hepatic patients and cardiac patients were having highest share of depression [n=51, 15.04%] and both anxiety and depression [n=32, 9.43%]. Most cardiac patients were depressed; most hepatic patients were anxious; almost half of cancer patients were both anxious and depressed; while majority of dermatological were having no psychiatric illness

Cytomorphological spectrum of neurosurgical lesions by crush smears cytology

To study the cyto-pathological appearance of intraoperative crush smears of neurosurgical biopsies after subsequent comparison with paraffin sections. Place and duration of study: The study was conducted at Armed Forces Institute of Pathology, Rawalpindi, for one year from February 2002 to February 2003. One hundred, neurosurgical biopsies were received for intraoperative consultation over a period of one year. Clinical information like age, gender, history, and CT scan or MRI findings were recorded. Crush smears were prepared, fixed in 95% alcohol and stained with rapid haematoxylin and eosin stains. Diagnosis was categorised into inflammatory, benign and malignant tumours considering the cyto-pathological features. Remaining tissue was fixed overnight in 10% formalin for histological sections. Permanent Haematoxylin and Eosin [H and E] sections were used as the "gold standard" for comparison. Out of 100 neurosurgical biopsies, crush smears of 94 were considered suitable for interpretation. The smears were categorised as, 8 inflammatory, 41 benign and 41 malignant tumours. Four cases were labelled as inconclusive. Eighty four of the crush smears diagnosis agreed with the histological diagnosis, cyto-morphology of the lesions on crush smear is discussed. Crush smears are useful in the intraoperative diagnosis of space occupying lesions of central nervous system as majority of the cases have typical diagnostic yield and cyto-morphology. We found crush smear cytology highly reliable, rapid and inexpensive mode of intraoperative diagnosis

Anxiety and depressive disorders as psychiatric co-morbidity in hepatic diseases

The study was designed to assess the co morbidity of anxiety and depressive disorders in the patients suffering from various hepatic diseases and to examine the split up of patients as per age, gender, marital status, family type, residence, occupation, income and type of hepatic disease diagnosis. Cross sectional study. The study was conduced from September 2007 to November 2007 in liver center DHQ hospital Faisalabad. 102 patients with different hepatic diseases participated in it through purposive convenient sampling technique. To diagnose the patients with anxiety and depression, the diagnostic criteria of DSM IV TR were employed while demographic variables were recorded on a demographic sheet. Results showed that anxiety and depressive disorders were found 88.2% co morbid in all hepatic patients. These psychiatric disorders were more frequently found in urban areas [57.63% anxiety and 37.3% depression] where as it was lesser in joint families [45.94% anxiety and 32.43% depression] and service personals [42.11% anxiety and 26.32% depression]. The proportion of the patients diagnosed with depression was higher in females and elderly, while it was lower in educated class. As the Psychiatric co morbidity especially anxiety and depressive disorders in patients suffering from hepatic disorders is so frequent hence the doctors dealing with such patients should be better trained in assessment and management of these disorders