Bacterial Spectrum and Antimicrobial Profile of Pediatric Blood Stream Infection at a Tertiary Care Hospital in Pakistan / 中国医学科学杂志(英文版)

Objectives Blood stream infections (BSIs) are the main cause of morbidity and mortality in children worldwide. The present study was carried out to determine the prevalence of BSI with a focus on the identification of the causative agent of BSI, and to further evaluate the antibiotic susceptibility profile of the causing bacterial pathogens.Methods A cross-section study was carried out at the tertiary care hospital in Peshawar, Pakistan from January to December, 2018. Blood samples were collected in BACTEC

Prevalence of allergic fungal sinusitis among patients with nasal polyps

Background: Nasal polyps are commonly seen in our routine ENT practice. Allergic Fungal Sinusitis [AFS] is also one of them

Objective: To determine the prevalence of allergic fungal sinusitis among patients with nasal polyps

Patients and Methods: This sectional study was conducted in Department of ENT, Sheikh Zayed Hospital, Rahim Yar Khan from 11[th] July, 2013 to 10[th] January 2014. This study included 84 patients with diagnosis of nasal polyps. All the patients were evaluated for the presence of allergic fungal sinusitis which was described as frequency and percentage. The data was collected in pre designed performa. The data was entered and analyzed by using SPSS version 16

Results: Allergic fungal sinusitis was detected in 9 [11%] patients. The mean age of the patients was 31 +/- 6 years, and all of the patients have, nasal obstruction, post nasal drip and sneezing

Conclusions: Allergic fungal sinusitis is seen commonly among patients with nasal polyps. So, every patient with nasal polyp should be evaluated for the presence of AFS

Audit of patients of epistaxis: treatment modalities and relation with blood groups

Background: Epistaxsis in one of the common condition faced in emergency

Objective: To evaluate the pattern of epistaxis, treatment, modalities and relation of epistaxis with blood groups

Patients and Methods: This retrospective the study was conducted at department of Ear, Nose, Throat, Head and Neck Surgery, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan from 1[st] January to 31[st] December 2010. Patients with spontaneous severe epistaxis who require hospitalization for control were included in this study and those who were with obvious cause like trauma, rhinolith, foreign bodies, granulomatous condition, tumours, blood dyscrasia and age below one year were excluded from this study. Data regarding age, gender, mode of presentation, under lying cause, blood groups and treatment modalities of consecutive 160 admitted cases of epistaxis was collected and analyzed by manual method and with the help of SPSS version 19. Sixty patients were excluded from this study because of blood dyscrasia, granulumatous disease and tumours. Trauma was not included in this study. To determine the association of blood grouping with opistaxsis 100 controls were also included in the study

Results: Hypertension above 50 years was the most common cause. It was more common in male patients [72%] as compared to in female. Sixty patients [60%] were above 50 years, twenty [20%] patients were in between [30 to 49] years, nine patients [9%] were in between [10 to 29] years and seven patients [7%] were in between [01 to 09] years of age. Hypertension was observed in sixty [60%] patients, chronic rhino sinusitis in twenty [20%]. Eighty five patients [85%] were managed by anterior nasal pack and in fifteen patients [15%] posterior nasal packing was done. Blood group [O] distribution was present in [47%], while in control group it was 38%

Conclusion: In adult admitted patients, hypertension was the major cause when trauma, granulomatous disease and blood dyscrasia was excluded. Anterior nasal packing is still valuable in control of epistaxis. Patients with blood group O was found in majority of patients of epistaxis

audit of the emergency tracheostomies in a tertiary care hospital

Background: Emergency tracheostomy remains a vital life saving procedure in advanced upper airway obstructive pathologies and in various other clinical settings where urgent alternative air passage is needed. Ingestions of hair dye powder containing PPD for self harm purpose or accidentally, is emerging as its new indication especially in young female patients

Objective: To evaluate the demographic and etiological factors underlying emergency tracheostomies in consecutive one hundred patients presenting in a tertiary care hospital

Subjects and Methods: In this case descriptive study, records of one hundred consecutive cases of emergency tracheostomies were collected and analyzed from demographic and etiologically point of view, from 1[st] January, 2012 to 30[th] September, 2013 manually as well as by using SSPS version 17

Results: Etiologically we found thirty five [35%] cases of severe respiratory distress due to kala pathar ingestion, thirty [30%] cases due to advanced laryngopharyngeal growths, twenty one[21%] due to trauma of head neck region or for assisting ventilation, four [4%] due to foreign bodies in laryngotracheal region, four[4%] cases were due to acute pharyngolaryngeal edema due to corrosive in take, four[4%] cases were due to post thyroidectomy bilateral abductor paralysis, one [1%] case was due to laryngomalacia and one [1%] case was due to acute epiglottitis male to female ratio was 1 to 1.5

Conclusion: Upper air way obstruction secondary to kala pathar ingestion is emerging as a new indication for emergency tracheostomy secondly, late presentation of upper airodigestive tract tumors, along with head neck trauma, remains a dominant indication for emergency tracheostomy

Mandibular fractures of maxillofacial skeleton- the epidemiology and management; a two years experience in a tertiary care hospital

Background: The incidence of maxillofacial skeleton fractures is rising sharply world wide, the main contributors being road side accidents, interpersonal violence and falls from heights. If not treated properly, such fractures may lead to life long functional and structural disability

Objective: This study was planned to determine demographics, clinical features, patterns of mandibular bone fractures, management, postoperative evaluation and regulatory aspects of causes of such fractures

Patients and methods: This was a descriptive study, based on data of 150 consecutive patients of facial skeleton fractures, from January 2008 to December 2009. Variables examined included demographic and clinical features, patterns of mandibular bone fractures and results of open and closed reduction of isolated mandibular fractures using surgical stainless steel wires. Patients were followed up for one year

Results: There were 135 [90%] male and 15 [10%] females, age ranged from 5-70 years [mean age was 25 years]. Most common causes were motor bike accidents [57%], and falls from different heights [16%]. Nasal bone was the most commonly fractured bone, seen in 112 [75%] patients, followed by mandible fractures in 80 patients. In s62, selected cases of mandibular fractures postoperative complication rate was higher in closed reduction than in open reduction cases with internal fixation [ORIF]

Conclusion: Long-term collection of epidemiological data regarding maxillofacial skeleton and management aspects of mandibular fractures are important for the evaluation of existing preventive measures and useful in the development of new methods of injury prevention and treatment

Hepatitis C; prevalence in paramedical staff of a teaching hospital

Hepatitis C is RNA virus isolated in 1988 but still no cultured in the laboratory. Hepatitis-C infection is a serious global public health issue, WHO estimates worlds 3% population is HCV positive. Pakistan is also facing the huge burden of this disease. Accurate prevalence information for hepatitis C infection is scant in Pakistan. Few population based studies are available, the most comprehensive being that of Luby et al which after testing a representative sample from a population of 150,000 in Hafizabad, Pakistan found an overall sero-prevalence of 6%. This increased to 30% with increasing age. They also found sero-prevalence of 16% in household members of HCV infected cases. Aslam et al reported a population prevalence of 16% from Lahore and 23.8% in Gujranwala. In our study published in Medical Forum showed prevalence of HCV antibodies in population attending our department of ophthalmology is 27.06%. There is no data from Pakistan about prevalence of hepatitis C in Paramedical staff. It appears that paramedical staff is at higher risk of contracting this infection as they are exposed to multiple risk factors like needle stick injuries. Little is known about the prevalence of Hepatitis C in this group of population. The objective of our study was to assess the perceived increased incidence of Hepatitis C in this group of population. The objective of our study was to assess the perceived increased incidence of Hepatitis C in this group of population. This is a retrospective audit of the data from the records kept by clinical laboratory on University Medical College, Faisalabad. All paramedical staff members were invited for HCV Antibody test on 13.1.2007 to 20.12007. Any staff member working in those days was included in the study. Persons on holidays or did not give free informed consent was excluded from the study. Serum of blood samples were analyzed by EXCEL a one step device for the qualitative detection of antibodies to Hepatitis C virus in serum or plasma by trained professional. This test has a relative sensitivity of 96.8%, relative specificity 99% and accuracy 98.9% as compared to HCV EIA test, Statistical analysis was performed by SPSS system. A total 80 staff members were working in the hospital at that time, 61 attended for the test [F:31,M:30]. We found 7 [11.4%] were HCV positive and 54 [88.52%] were HCV negative including 2 weekly positive. Among HCV positive 4 [6.55%] were male and 3 [4.91%] were females. Age distribution was 17-75 years with mean age 32.51 years. Among HCV positive 3 were analyzed by ELISA technique. 2 weekly positive by EXCEL were negative by ELISA and 1 positive by EXCEL was positive by ELISA. Paramedical staff is perhaps not at higher risk of contracting HCV infection. However more studies are required to further assess this finding

Hepatitis B antigenaemia

The prevalence of hepatitis B virus infection is a global health issue including Pakistan, causing considerable morbidity and mortality from its chronic sequelae including chornic hepatitis, cirrhosis and liver cancer particularly when HBV infection is acquired early in life. The present study was undertaken with the object to find out the current HBV infection rate and any age and sex differentiation in the population of Faisalabad. This studied was carried out at Madina Teaching Hospital, Faisalabad, from May 2005 to April 2007. A descriptive, hospital based study. Blood was collected by approved medical techniques for HBsAg immunochromatographic devices were used to screen blood. HBs antigen positivity in Faisalabad is currently 1.55%. A significant majority of reactive cases belonged to the male gender [72.91%] and the young age groups 2-4 [43.75%]. Upon analyzed the results of this study, it was revealed that the number of HBV infected subjects isolated is rather low in this area but the given figure is still notable in view of its high prevalence in the young age group

Osteoporosis; prevalence among the post menopausal women

To Study the prevalence of osteoporosis among post menopausal women in the Faisalabad city and compare that with other developed and developing countries. A Cross Sectional Study. Medina Teaching Hospital Faisalabad and Al Bari Hospital Faisalabad from February 2008 to April 2008. A total of 300 post menopausal women were included after valid consent and observing inclusion and exclusion criteria. Quantitative Ultrasound Device [QUO] that is BMD was assessed from the heel of each participant. T-Scores were obtained and WHO classification was followed. A scale was used to assess the Body Mass Index measuring height and weight. Data collection sheet having structured questions was used for checklist for obtaining pertinent information. Out of 300 post menopausal women overall prevalence of Osteoporosis [OP] was 20%. Further, 44% were Osteopenic. Results were comparable with other countries as well. Osteoporosis [OP] is not uncommon in our country. It should be considered as a Public Health Problem. Early screening and prompt treatment can prevent the heavy cost on fracture managements. In Pakistan, even in Asia Key data is not available to convince Policy makers that OP is a serious burden on population and to invest in prevention is the better option. Health Education is imperative for target population

Pre-operative screening for HBV and HCV infections: a preventive measure! Where are we today?

Viral hepatitis B and C are common causes of chronic liver disease and a major public health issue all over the world. Chronic hepatitis B and hepatitis C infections are indolent, often subclinical diseases that may lead to cirrhosis and hepatocellular carcinoma after decades. In this study, our aim was to find out the frequency of HBsAg and Anti-HCV in the subjects planned to undergo eye surgery and to stress the importance of pre-operative screening by using cost effective immunochromatographic test kits. Subjects of both genders [n=6340] attending Madina Teaching Hospital, Faisalabad for ophthalmic surgery were randomly selected as study subjects and were screened for HBsAg and Anti-HCV during the pre-operative period. This study was conducted for a period of 27 months, in Faisalabad, Pakistan. Blood specimens were collected and tested for the qualitative detection of HBsAg and Anti-HCV in serum using simple, one step immunochromatographic assay. Our study was conducted in hospital based population and a total of 6340 subjects were screened for both hepatitis B and C. The carrier state of hepatitis was detected in 19.97% of the subjects. The prevalence of HCV among the total cases studied was 17.85%, hepatitis B, 1.35% and hepatitis B and C [dual infection] 0.46%. More than half [51.06%] of the adults: 60 years of age were HCV seropositive indicating a strong increase in the older age group. A higher percentage of male subjects showed positive results for HBsAg as compared to females but this difference was insignificant in Anti-HCV reactive subjects. This study concludes that frequency of HCV infection is quite high in the studied population and is much higher than that of HBV infection that is much lower in this population. Routine and preoperative screening for HBV and HCV infection can help reduction in transmission of infection. The simple and accurate ICT for HBsAg and Anti-HCV immunoassays provide a flexible, technically undemandable and relatively inexpensive approach to ensure a safer blood supply and pre-operative screening of surgical patients and donors

Prevalence of diabetes mellitus among obese people in Faisalabad

Remarkable increases in obesity have occurred all over the world particularly in the last decade. This is true even for the developing countries. Excess weight is a high risk factor for diabetes in both men and women, especially those with excess abdominal fat. The reason has been attributed to the growing insulin resistance. The prevalence of diabetes mellitus in obese general public is 30% in the international literature. It is less studied in Pakistani. population living in Pakistan. To study the prevalence of raised blood sugar among obese persons in a population attending Madina Teaching Hospital, Faisalabad. A questionnaire containing personal and socioeconomic information was completed for each participant. Height, weight, and waist circumference were recorded by trained professionals and BMI was calculated. BMI more than 30 was inclusion criteria. Blood sugar was performed from a venous blood sample analyzed by Merck, Microlab 300 semiautomatic chemistry analyzer with Biocon, Germany's, Fluitest GLU, GOD - PAP reagent. Data was analyzed by SPSS statistical tool. A total of 40 [M: 17, F: 23] subjects were included in the study, among whom 8 [20%] had raised random blood sugar in diabetic range. Two of the 8 raised blood sugar group knew they had diabetes mellitus on subsequent questioning and 6 were told first time they have diabetes mellitus. Obesity is a significant risk factor for the development of diabetes mellitus and we recommend every obese person in general public should have their blood sugar measured to make an earlier diagnosis to reduce the subsequent risk of complications. Furthermore health education may be imparted to general population. This is perhaps the only cost effective way to address the issue of diabetes and "double burden of diseases" which Pakistan is facing

Prevalence of hepatitis-C in Faisalabad region of Pakistan

To study the prevalence of HCV in a population attending Madina Teaching Hospital, Faisalabad for ophthalmic procedures. It is a retrospective audit of patients found to be HCV positive on routine testing, attending Madina Teaching hospital, Faisalabad for ophthalmic procedures. Anybody who required a surgical intervention is routinely screened for hepatitis B and hepatitis C in this department for last number of years. A total of 1027 patients from June 2007 to August 2007 [3 months] were selected for the study. Among them 278 [27.06%] were found to have HCV antibodies in their serum and 749 [72.93%] were HCV antibody negative. In HCV positive group 158 were males [56.83%] and 120 females [43.16%]. Furthermore it was more prevalent in age group 50 - 70 years in both sexes. Hepatitis C is significantly more prevalent in Faisalabad region than reported previously. Also it is more common in age group 50 to 70 years and is equally distributed in both sexes. Cause [s] of this distribution is unknown and should be investigated

Management of oesophageal foreign bodies

To evaluate management of oesophageal foreign bodies. Cross sectional analytic study. Department of otorhinolaryngology and head and neck surgery Bahawal Victoria Hospital Bahawalpur, from May 2003 to December 2004. A total of 186 patients with history of foreign body ingestion were admitted and included in the study. A structured questionnaire was designed to record the informations. X-ray neck and rigid oesophagoscopy was carried out to diagnose and remove foreign bodies. Out of 186 patients, 155[83.33%] were from paediatric age group and 31[16.66%] above 12 years of age. Coin was the commonest foreign body [77.41%]. Dysphagia was the commonest symptom [96.77%]. X-rays were conclusive in 181[97.3%] patients. Rigid oesophagoscopy was carried out in all cases and removal of foreign body was successful in 95.69% cases, and complication rate was very low