Recovery of Schistosoma haematobium ovum from Labeo rohita: first report from Pakistan

Schistosomiasis, also known as bilharzia, is a parasitic disease caused by trematodes from the genus Schistosoma that can infect humans and animals. S. mansoni, S. japonicum, and S. mekongi all causes intestinal schistosomiasis except S. haematobium that causes urinary schistosomiasis. It is only specie which effects urinary system, it can affect liver, heart, lungs also but very rarely. Schistosoma haematobium is endemic to over 50 countries in Africa and the Middle East and Western Asia and may be fatal in HIV positive people. A number of reports from the African countries like Nigeria have been reported. A few cases are reported 9but in Pakistan it has never been reported before in native people. It is first time reported in Pakistan in the intestine of Rahu (Labeo rohita). The purpose of this study is to elaborate the approach of zoonotic agent by various other routes including the commonly available fish

Clinical spectrum of typhoid fever in children

One of the most important health problem in Pakistan and other developing countries is Enteric Fever. As the definitive diagnosis of typhoid fever requires certain laboratory tests, emphasis must be given to clinical diagnosis of typhoid fever especially in communities where laboratory services are not available, so that a rapid diagnosis can be made and appropuate treatment started on clinical grounds without waiting for laboratory investigations. A descriptive study was carried out on 80 patients admitted in Paeds Ward Jinnah Hospital Lahore from June 2003 to June 2004 with strong suspicion of typhoid fever. These patients were either blood culture or widal test positive. Out of 80 admitted patients,29 were female and 51 were male. Maximum incidence was seen in children between 5-15 years of age Fever was the most consistent feature in all patients which was mostly high grade and remittent. The important physical findings were coated tongue and hepatosplenomegaly

Frequency of hepatitis-C virus infection in patients on maintenance haemodialysis in Nishtar Hospital Multan

To determine the frequency of hepatitis-C virus infection in patients on maintenance haemodialysis in Nishtar Hospital Multan. Simple descriptive cross sectional. Thirty patients of maintenance haemodialysis for atleast six months twice daily haemodialysis were included. From April 2003 to March 2004. Thirty patients out of whom 20 were male and 10 were female. Patients between the age of 16 to 60 were included in the study. All the patients were on haemodialysis for more than six months and were receiving dialysis therapy twice week. Diagnosis of HCV infection was made by detection of HCV antibody with the help of kit. Name of the kit used was ACON hepatitis C Virus Rapid Test Strip [Serum]. This was a qualitative membrane based immunoassay for the detection of antibody to HCV in serum. Frequency of anti HCV among patients of maintenance haemodialysis was found to be 26.7% [8/30]. Role of different risk factors for the transmission of HCV during haemodialysis were quite conclusive. History of blood transfusion and duration of haemodialysis were the main factors in transmission of anti HCV to the patients of maintenance haemodialysis. The Frequency of anti HCV among patients on maintenance haemodialysis was 36.7%

Comparison of snod gross and para-meatal based flap technique for hypospadiasis

To compare the two surgical procedures Snod gross and parameatal based flap technique for mid and distal penile hypospadias including cosmosis. Randomized Clinical interventional trail. This study was conducted in the Urology Department of Assir Central University Hospital ABHA, KSA and Department of Urology and Renal transplantation, Jinnah Hospital, Lahore from June 2002 to Dec 2004. Thirty-two patients were selected for this randomized clinical intervention study with mid shaft and distal hypospadias fulfilling the inclusion criteria. Snod Gross and parameatal based flap technique was assigned randomly to patients comprising of two groups of sixteen each. Watertight closure was made with 6/0 vicryl. Tourniquet or 1:10000 epinephrine were used. Follow up at 2 weeks, three months; 6 months post catheter or stent removal and the patient were assessed on criteria of cosmosis, time for surgery and complications associated with the procedure. Thirty-two patients who underwent procedure of Snodgross and parameatal-based flap in the management of mid shaft and distal penile Hypospadias. Age ranged from 2-12 years. The mean age was 5.23+4 years. The presentation of patients was dystocia of external meatus with misdirected stream in sixteen [50%] patients, spraying of urine in six [25%] and narrow stream in 4[13%] patients. Eighteen patients were having distal penile and fourteen were having mid shaft hypospadias. Following Snod grass technique all patients had good cosmetic results without any complication. Following parameatal based flap, one patients [6.3%] develop wound dehiscence, three patients [18.8%] develop urethral fistula, two patients [12.5%] showed metal retrieval and twenty patients showed good cosmosis. In our study, comparison between Snodgross and parameatal-based flap, the success rate was 100% and 62.4% respectively. Success with Snod gross procedure is better with no complications and good cosmosis. Complications rate was 37.6% in-patient with para-meatal technique

Hyper IgE syndrome

Hyper immunoglobulin E syndrome is a rare disease. We report a case of a 2, 1/2 years old girl of consanguineous parents who presented with recurrent staphylococcal infections, failure to thrive and death of four siblings with similar illness. CBC revealed a peripheral eosinophilia and serum IgE level was markedly, raised which led to the diagnosis of hyper IgE syndrome

Management of post traumatic posterior urethral sticture; internal urethrotomy versus perennial urethroplasty

To compare the efficacy and cost effectiveness of cold knife optical internal urethrotomy with perineal urethroplasty [excision and end to end anastomosis] in the management of post traumatic short posterior urethral stricture. Design: an observational prospective study. Place and duration of study: the study was performed in the department of urology and kidney transplantation Services hospital/post graduate medical institute Lahore, from September 1997 to December 1999. Patients and methods: Forty male patients of post traumatic posterior urethral stricture revealed by their urethrogram were included in the study. Patients were divided in two groups randomly [group A and group B]. After complete evaluation, patients of group A were managed by internal uretherotomy, while those of group B by perineal urethroplasty. Follow up was done at 1,3,6,9 and 12 months. age range of the patients was 20 to 59 years with the mean age of 35.5 years. Road traffic accident was the main cause [82.5%]. After facing the traumatic urethral injury, there was history of attempted Foley catheterization [47.5%], bouginage [15%] and intervention by rail road technique in 10% of the patients. All patients were with supra pubic catheter because of failure to void. The length of stricture varied from 0.5 to 2.0 cm [mean 1.4 cm]. Clinical response at the end of the study in group A and B was "good" in 58.82% and 66.66%, "satisfactory" in 23.52% and 22.22% and "poor" in 17.64% and 11.11% respectively. The mean cost of operation, hospital stay and loss of working hours were less in group A as compared to that of group B. The results of perineal urethroplasty are comparatively better than optical urethrotomy. The other differences of the two procedures lie in operative time cost of the operation and mean hospital stay. It is concluded that optical urethrotomy is an acceptable alternative to urethroplasty in patients with short post traumatic posterior urethral stricture

Pattern of drug resistance in tuberculosis

To estimate drug resistance in TB patients and compare it with previous studies to see the changing trends. This work was done at the TB Research center of Pakistan Medical Research Centre at Mayo hospital Lahore from 2000 to 2003. The center receives specimens from all the leading hospitals of Lahore. Five first line anti tuberculosis drugs were tested on LJ medium using proportion method. A total of 894 confirmed isolates of Mycobacterium tuberculosis [759 pulmonary and 135 extra pulmonary] from 894 patients, with and without history of previous treatment, were subjected to drug susceptibility testing about 50% of the patients had some resistance. Multiple drug resistance [MDR] was found in 12% and 23% without and with history of previous treatment respectively. Overall resistance to rifampicin was 28.6%, isoniazid 25.6%, streptomycin 23.8%, ethambutol 14.5%, and pyrazinamide 29.3%. Statistically significant difference was seen between primary and acquired resistances. Results when compared with the previous studies from the same area showed a gradual increase in drug resistance. Resistance to anti tuberculosis drugs in Lahore is high and needs to be addressed in the national tuberculosis control program and in the implementation of DOTS program in the country

Clinical spectrum of typhoid fever in children

One of the most important health problem in Pakistan and other developing countries is Enteric Fever. As the definitive diagnosis of typhoid fever requires certain laboratory Tests, emphasis must be given to clinical diagnosis of typhoid fever especially in communities where laboratory services are not available, so that a rapid diagnosis can be made and appropriate treatment started on clinical grounds without waiting for laboratory investigations. A descriptive study was carried out on 80 patients admitted in Paeds ward Jinnah Hospital Lahore from June 2003 to June 2004 with strong suspicion of typhoid fever. These patients were either blood culture or widal test positive. Out of 80 admitted patients, 29 were female and 51 were male. Maximum incidence was seen in children between 5-15 years of age. Fever was the most consistent feature in all patients which was mostly high grade and remittent. The important physical findings were coated tongue and hepatosplenomegaly

Autosomal dominant dyskeratosis congenita with carcinoma oesophagus

A rare case of oesophageal squamous cell carcinoma with reticular pigmentation all over the body is being reported. He was suffering from dystrophic changes in all the finger and toe nails and he was diagnosed as suffering from autosomal dominant dyskeratosis congenita