Use of botulinum A toxin [BOTOX] in different types of facial dystonia

This study was carried out in the Eye Departments of Combined Military Hospital, Kharian and Military Hospital, Rawalpindi, from January 2007 to August 2008. To determine the effects of botulinum A toxin [Botox] injection in different types of facial dystonia. A total of 23 botulinum A toxin [Botox] injections were given in 13 patients including 7 males and 6 females. Patients were followed up at 1 week, 6 weeks and 6 months after the injection. The indications were essential blepharospasm in 4 [30.77%] cases and hemifacial spasms in 9 [69.23%] cases. Age ranged from 28 to 60 years [mean 41 +/- 12 years]. Four patients were given injections three times and 2 patients were injected twice. Onset of action of botulinum A toxin [Botox] was variable, starting on the same day in 3 patients while in the rest of patients it started on the next day. Mean duration of action was 12.77 weeks +/- 4.68 [range 6-23 weeks]. Dystonia improved in all the cases. Temporary slight facial paresis and lagophthalmos occurred in 3 [23%] cases while ptosis occurred in 2 [15.4%] cases. Two patients [15%] had mild ocular irritation and conjunctival congestion after injection, which settled with topical mild steroid [fluorometholone]. Botulinum A toxin [Botox] is useful treatment for different types of facial dystonia

Knowledge, attitudes and practices to lifestyle risk factors for coronary heart disease [CHD] and diabetes amongst South Asians in North Kirklees, England - a focus group study

The aim of the study was to identify and explore main issues relating to knowledge, attitudes and practices to lifestyle risk factors for coronary heart disease [CHD] and Diabetes amongst South Asians in North Kirklees, UK. A comparative study. The study was conducted in North Kirklees, UK from April 2001 to March 2002. A focus group approach from qualitative research methodology was used. South Asians already attending community centers for different activities were selected randomly. Group discussions were taped and translated. Main issues were identified by analyzing these transcripts using qualitative methodology. A variety of attitudes and different levels of knowledge and practices to lifestyle risk factors for coronary heart disease [CHD] and Diabetes have been observed. The main issues identified were language barrier, lack of individually tailored information, cultural and religious barriers such as lack of women-only facilities. Other barriers which have been highlighted by the study were diet, lack of physical activity and stress. Stress has also been identified as an important cause of CHD leading to Diabetes especially in South Asians [SA]. The health care professionals need to be aware of knowledge, attitudes and culturally sensitive issues of South Asians to potential diseases in order to undertake effective preventive measures by avoiding being prejudice. Inspite of provision of communication assistants South Asians still face problems accessing health and leisure services due to language barriers. The issue of stress amongst South Asians needs to be recognized as an important issue. Hence it is important to assess the health and social needs of SA independently in order to deliver high quality and effective health care

Analysis of early appendectomies for suspected acute appendicitis: a prospective study

A prospective study of 210 cases undergoing early appendicectomies for suspected acute appendicitis is presented. The diagnosis was based on detailed history and clinical examination with limited investigations. There was a 7.2 percent incidence of negative appendicectomies with a 13.3 percent rate of complications. The overall morbidity was 9.5 percent. The incidence of post-operative complications was 37.2 percent in the complicated group as opposed to 8.9 percent in the un-complicated appendicitis and zero percent in negative explorations. An aggressive and prompt approach is recommended to lower the incidence of perforated appendicitis and hence postoperative morbidity