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Enteric fever commonly known as typhoid fever remains endemic in many developing countries with an estimate of more than 26.9 million cases recorded annually with 1% associated deaths. We conducted a study to evaluate clinico-epidemiological profile of enteric fever in a peripheral hospital of Kashmir North India. This was a hospital based cross sectional study conducted over a period of one year including a total of 100 patients between 1-12 years of age. All children who have documented fever of more than one week duration with widal titres of >160 were included in the study. Among 100 patients included in the study 94% had fever of >1 week of duration, 68% and 50% had anorexia and vomiting respectively. Diarrhea was present in 28% of the study population with constipation in 10%. 28% had hepatomegaly on examination while as 12% had spleenomegaly. Headache was present in 17% of population. Our study concluded that enteric fever continues to be a significant cause of morbidity and mortality in developing nations especially in the rural population. Poor hygiene, lack of proper community education, limited healthy care facilities and negligible typhoid vaccination are the main concerns which need to be addressed on priority to decrease the disease burden.
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Introduction: Laparoscopy has revolutionised Surgerywith its widespread acceptance as predominantly minimallyinvasive to intraabdominal surgical procedures. Creationof pneumoperitoneum is indispensable primary step ofthe procedure as it allows creation of operative field. Itcan be achieved by various techniques viz Classical openmethod as described by Hasson. The aim of the study wasto ascertain safety of direct trocar insertion in creation ofpneumoperitoneum in laparoscopic surgeries and adopt thesame as an alternative to veress technique.Material and methods: A total of 576 patients were includedin the study, Group A comprised of patients in whom wecreated pneumoperitoneum by classical veress needleinsertion and included 327 patients. Group B comprised of249 patients in whom we created pneumoperitoneum by directtrocar insertion method.Results: The mean age of patients was 47.54 years SD 11 witha male female ratio of 1:1.56. Laparoscopic cholecystectomy(52.08%) was most frequent followed by laparoscopicappendectomy (13.02%). Group A patients witnessed omentalemphysema (7.95%) as commonest complication followed bypreperitoneal insufflation(5.19%) while as the most commoncomplication in group B was omental emphysema (0.81%).Port site infection (4.28%) and subcutaneous emphysema(3.36%) predominated in group A and port site infection(1.2%) and seroma formation (1.2%) were common in groupB.Conclusion: There are many methods to createpneumoperitoneum. The closed technique modified to directtrocar insertion versus classical method by Veress werecompared in patients undergoing laparocopic proceduresat SMHS hospital for a period of one and a half year. Theresults are fascinating as the modified technique overshadowsits classical version in terms of feasibility, efficacy andconsumption of time.
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Infection due to hepatitis C virus (HCV) is a major cause of fibrosis and hepatocellular carcinoma in Pakistan. In the current review, pattern of HCV genotypes and subtypes in Khyber Pakhtunkhwa province was ascertained in light of the available literature. After thorough analysis, genotype 3 (58.27%) was determined to be the leading HCV genotype, followed by genotypes 2 (12.39%), 1 (9.54%) and 4 (0.86%). The proportions of genotypes 5 and 6 were recorded as 0.09% and 0.22% respectively. Subtype wise, 3a accounted for 48.67%, followed by subtype 2a (10.91%), 3b (9.43%), 1a (5.84%), 1b (3.66%), 2b (1.45%) and genotype 4 with its undefined subtypes contributed a portion of 0.86%. The cumulative share of subtypes 1c, 2c, 3c, 5a and 6a was less than 1%. In 11.51% cases, the subtype was untypeable while in 7.17% cases mixed subtypes were recorded. Gender wise, proportions of most HCV subtypes were marginally higher among males as compared to females. On the basis of studied groups, 3a was pervasive among all groups except in intravenous drug users where 2a was the major HCV subtype. Similarly, based on various geographical locations (provincial divisions), subtype 3a revealed a ubiquitous distribution. Conclusively, HCV 3a persists to be the principal subtype across the province of Khyber Pakhtunkhwa. The considerable number of untypeable subtypes in most studies urges for an improved genotyping system on the basis of local sequence data and practice of sequencing for determination of underlying subtype in untypeable cases. Further, studies on identification of subtypes transmission pattern are imperative for assessment of transmission origin and reinforcement of efficient control strategies. In addition, the current review emphasizes the need of attention toward HCV risk groups and ignored southern side of Khyber Pakhtunkhwa province for better holistic understanding of HCV genotype distribution pattern in the province.
ABSTRACT
Infection due to hepatitis C virus (HCV) is a major cause of fibrosis and hepatocellular carcinoma in Pakistan. In the current review, pattern of HCV genotypes and subtypes in Khyber Pakhtunkhwa province was ascertained in light of the available literature. After thorough analysis, genotype 3 (58.27%) was determined to be the leading HCV genotype, followed by genotypes 2 (12.39%), 1 (9.54%) and 4 (0.86%). The proportions of genotypes 5 and 6 were recorded as 0.09% and 0.22% respectively. Subtype wise, 3a accounted for 48.67%, followed by subtype 2a (10.91%), 3b (9.43%), 1a (5.84%), 1b (3.66%), 2b (1.45%) and genotype 4 with its undefined subtypes contributed a portion of 0.86%. The cumulative share of subtypes 1c, 2c, 3c, 5a and 6a was less than 1%. In 11.51% cases, the subtype was untypeable while in 7.17% cases mixed subtypes were recorded. Gender wise, proportions of most HCV subtypes were marginally higher among males as compared to females. On the basis of studied groups, 3a was pervasive among all groups except in intravenous drug users where 2a was the major HCV subtype. Similarly, based on various geographical locations (provincial divisions), subtype 3a revealed a ubiquitous distribution. Conclusively, HCV 3a persists to be the principal subtype across the province of Khyber Pakhtunkhwa. The considerable number of untypeable subtypes in most studies urges for an improved genotyping system on the basis of local sequence data and practice of sequencing for determination of underlying subtype in untypeable cases. Further, studies on identification of subtypes transmission pattern are imperative for assessment of transmission origin and reinforcement of efficient control strategies. In addition, the current review emphasizes the need of attention toward HCV risk groups and ignored southern side of Khyber Pakhtunkhwa province for better holistic understanding of HCV genotype distribution pattern in the province.
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The treatment methods of the fractures of humerus are treated in many ways. Interlocking nails and plates have both stood the test of time but the present study looks at both methods scientifically. Prospective, comparative study. This study was carried out at Ghazi Medical College, D.G.Khan from 07.01.2013 to25.02.2015. A total of 40 patients were included in the study. It was a, study of two groups of patients of fractures of humerus treated with dynamic compression plate versus with interlocking nails. Fractures in both groups healed uneventfully without significant complications. Both modes of treatment can be recommended for the treatment of fractures of the shaft of Humerus with minimal chances of complications
Subject(s)
Humans , Adult , Female , Male , Humerus , Retrospective Studies , Prospective Studies , Humeral Fractures , Bone NailsABSTRACT
Objective: to determine seasonal variation in the occurrence of stroke and its subtypes [ischemic stroke and hemorrhagic stroke] during summer and winter and to observe the frequency of common risk factors for stroke
Methodology: the present descriptive study was conducted in the Department of Medicine, MTI Lady Reading Hospital Peshawar, Khyber Pakhtunkhwa, Pakistan, over a period of one year from 1st January 2014 to 31st December 2014. A total of 321 patients of any age and either gender were included. The diagnosis was established based on history, clinical examination and supplemented by CT scan of brain
Results: in winter 58.56% of patients and in summer 41.48% of patients were presented. Ischemic stroke was present in 66.04% patients while hemorrhagic stroke in 33.95% patients. Males had more strokes as compared to females [60.75% Vs. 39.25%]. In males highest number of strokes was found in 60-69 age groups whereas in females it was in 50-59 age groups. In winter the strokes increased in all age groups comparative to summer. Hypertension [34.26%] was the highest risk factor for stroke
Conclusion: stroke showed seasonal variation. Winter season was associated with increased frequency of stroke and its subtype of hemorrhagic stroke. There was variation of gender, season and stroke types in different age groups. Hypertension was found to be the highest risk factor
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To assess the frequency of hydrocephalus in postoperative cases of myelomeningocele and the need of ventriculoperitoneal shunt placement. Descriptive study CMH Rawalpindi from Sep 2008 to Nov 2009. Forty patients of either sex with myelomeningocele were included. These patients did not have hydrocephalus at the time of presentation. They were operated upon for myelomeningocele. Postoperative follow up was carried out at 1, 2 and 3 months to look for the development of hydrocephalus. Data was analyzed using SPSS version 17. Out of forty patients 22 [55%] were males and 18 [45%] were females. The age ranged from newborn to 10 months. Thirty five [87.5%] patients had lumbosacral myelomeningocele, 2 [5%] patients thoracic, 2[5%] patients cervical while one patient [2.5%] presented with both cervical and lumbosacral myelomeningocele. Postoperatively 21 [52.5%] patients developed hydrocephalus which were subsequently confirmed on CT scan head and were then subjected to ventriculoperitoneal shunting. High frequency of hydrocephalus was observed in postoperative cases of myelomeningocele and patients presenting with one entity must be looked for the other. Postoperative cases of myelomeningocele should be regularly followed for the evidence of hydrocephalus
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Pakistan is rich in plants of significant medicinal value whereas masses are unaware of theit significance and production technology. Therefore a brief account of significance and production technology of some important spices is described in this paper to.encourage progressive growers to cultivate these on commercial basis and get better returns per unit land along with saving valuable foreign exchange