Guideline for diagnosis and treatment of spine trauma in the epidemic of COVID-19 / 中华创伤杂志(英文版)

Outbreak of COVID-19 is ongoing all over the world. Spine trauma is one of the most common types of trauma and will probably be encountered during the fight against COVID-19 and resumption of work and production. Patients with unstable spine fractures or continuous deterioration of neurological function require emergency surgery. The COVID-19 epidemic has brought tremendous challenges to the diagnosis and treatment of such patients. To coordinate the diagnosis and treatment of infectious disease prevention and spine trauma so as to formulate a rigorous diagnosis and treatment plan and to reduce the disability and mortality of the disease, multidisciplinary collaboration is needed. This expert consensus is formulated in order to (1) prevent and control the epidemic, (2) diagnose and treat patients with spine trauma reasonably, and (3) reduce the risk of cross-infection between patients and medical personnel during the treatment.

Histopathological pattern of glomerular lesions on percutaneous renal biopsy in proteinuric patients

Objective: To determine the histopathological pattern of glomerular lesions on per-cutaneous renal biopsy in patients presenting with proteinuria

Study Design: Cross-sectional descriptive study

Place and Duration of Study: Department of Medicine, Combined Military Hospital Peshawar, from Aug 2012 to May 2015

Material and Methods: From the adult patients undergoing renal biopsy for various indications in our department, we selected a cohort of 200 patients who had proteinuria of >/= 1 gram/24 hours on presentation. A percutaneous renal biopsy was performed in these patients and the specimens were subjected to histopathology and immunofluorescence studies. The results of biopsy findings were considered along with other clinical and laboratory data to reach conclusive clinico-histopathological diagnoses of various glomerular diseases

Results: Most patients with proteinuria [91%, n=182] have glomerular disease. Among glomerular diseases, primary ones are more common [69.8%] than secondary disorders [26.9%]. In our study cohort, focal segmental glomerulosclerosis is the most common diagnosis [23%], while lupus nephritisis the most common secondary glomerular disorder [7%]. Other common glomerular disorders are membranous nephropathy [12%], IgA nephropathy [9%], and post-infectious glomerulonephritis [6%]

Conclusion: Glomerular disease is common in patients presenting with proteinuria. Its histopathological pattern appears similar to that mentioned in many other studies of the region

Frequency of retinopathy in type 2 diabetic patients with or without microalbuminuria

Objective: To determine the association of diabetic retinopathy among type 2 diabetic patients with microalbuminuria

Study Design: Comparative cross-sectional study

Place and Duration of Study: Medical wards combined Military Hospital Peshawar from 12[th] Jim to 12[th] Dec 2013

Material and Methods: One hundred and eighty six patients [93 in each group] with type 2 diabetes fulfilling the inclusion criteria were included in study through consecutive sampling

A standard protocol was followed for testing spot urine for micro, on the basis of which patients were divided into cases and control groups depending upon presence or absence of microalbuminuria. Fundos copy was done for any evidence of diabetic retinopathy including micro aneurysms dot and blot hemorrhages, new vessel formation and maculopathy

Results: 51.61% [n=48] in cases and 29.03% [n=27] in controls were having diabetic retinopathy while remaining 48.39% [n=45] in cases and 70.97% [n=66] in controls were not having diabetic retinopathy

Conclusion: We concluded a significant association between diabetic retinopathy and microalbuminuria

Myeloid sarcoma in a child with acute myeloblastic leukaemia

We report a rare occurrence of myeloid sarcoma in a 7 years old child with acute myeloblastic leukaemia [AML - FAB type M[2]]. He presented with fever, generalized weakness, bilateral proptosis and left parotid swelling. CT scan revealed a mass in paranasal sinuses extending into brain and retro-orbital region. Diagnosis of AML M[2] was made on bone marrow aspiration and special stains. Induction therapy for AML was given according to standard protocol. The extramedullary lesion as well as the acute leukaemia went into complete remission

Effect of potassium channel blockers on morphine induced analgesia

Present study was conducted to see the effect of potassium channel blockers, 4-aminopyridin [4-AP], Tetraethylammoniumchloride [TEA[+]C1] and Quininehydrochloride on morphine induced analgesia in rats. Charles Foster albino rats [either sex] weighing between 100-200 gm were selected and divided into four groups of six each. Group I was selected as control and treated with 'normal saline, Group II was treated with 4-AP, Group III was treated with TEA [+] Cl and Group IV was given Quinine hydrochloride. After treatment with potassium channel blockers analgesia was induced in all groups by giving morphine sulphate and reaction time to pain was noted in seconds. The mean reaction time was reduced in all the three groups as compared to the control group. This effect could be attributed to the effect of potassium channel blockade on the release of neurotransmitters

Endobronchial tuberculosis: clinical and diagnostic aspects

This study was conducted at the Department of Pulmonology, Military Hospital Rawalpindi from Jan 1990 to Dec 2000 to determine common clinical features and diagnostic aspects especially bronchoscopic characteristics of endobronchial tuberculosis. A total of 180 consecutive cases of Endobronchial Tuberculosis of all ages and both sexes were included. The mean age was 29.82 ['4.32] years. Male to Female ratio was 2.4:1. Cough was the most common symptom [90.59%] with expectoration in 50.55% patients. Fever and hemoptysis were noted in 83 and 67 cases respectively. History of weight loss was present in 20.55% patients while chest pain and exertional dyspnea were noted in 17.77% and 13.33% cases respectively. Chest X-rays were normal in 77.77% cases. Endobronchial lesions on bronchoscopy were noted in upper lobes in 59.74% cases while lower lobe lesions were seen in 40 [25.97%] cases and 22 [14.28%] patients had involvement of right middle lobe or major bronchi. Endobronchial secretions yield for AFB positivity was cent% and commonest histopathological feature was non caseating granuloma. Endobronchial tuberculosis is not an uncommon entity but due to non specific symptomatology and normal chest X-ray, a high index of clinical suspicion is required for timely diagnosis and appropriate management. Fiberoptic bronchoscopy with biopsy and bronchial washings is the investigation of choice