Road traffic injuries in Rawalpindi city, Pakistan

Data on road traffic accident [RTA] injuries and their outcome are scarce in Pakistan. This study assessed patterns of RTA injuries reported in Rawalpindi city using standard surveillance methods. All RTA injury patients presenting to emergency departments of 3 tertiary care facilities from July 2007 to June 2008 were included. RTA injuries [n=19 828] accounted for 31.7% of all injuries. Among children aged 0-14 years females suffered twice as many RTA injuries as males [21.3% versus 11.4%], whereas this trend reversed for the age group 15-24 years [41.9% versus 21.7%]. One-fifth of injuries were either fractures or concussion. Severity and outcome of injuries were worse for the age group 45 years and older. For every road traffic death in Rawalpindi city, 29 more people were hospitalized and 177 more received emergency department care. These results suggest the need for better RTA injury surveillance to identify preventive and control measures for the increasingly high road disease burden in this city

Perinatal mortality contributors in singleton gestation

To determine the feto-maternal factors contributing to perinatal mortality [PNM] in singleton gestation. Descriptive study. Gynae Unit-III, Civil Hospital, Karachi, from January to December 2002. All obstetric patients with singleton pregnancy and gestation age greater than 24 weeks, regardless of age, parity and gravidity attending the gynae unit III in labor room and ward were recruited. Patients with gestational age less than 24 weeks or multiple pregnancy were excluded. Relevant data regarding history, risk factors in mother and baby were recorded on a pre-designed proforma and later analyzed on SPSS 10 for descriptive statistics and comparison of proportions using chi-square statistics. Neonatal death was defined as live born infant who died before 28 days of age. Still birth encompassed any death of a fetus after 20 weeks of gestation or 500 gms, and perinatal mortality was considered as the sum of the still birth and neonatal death. In the 1505 studied mothers, the perinatal loss was 187[12.43%] including 140 still births and 47 neonatal deaths [3.12%]. Perinatal mortality rate [PNMR] was 124/1000 total live births and neonatal death rate [NNDR] was 34/1000 live births. The commonest cause of still birth was antepartum hemorrhage [33.5%] and the commonest cause of NND was birth asphyxia [64%]. PNM in relation to neonatal birth weight was highest in the 2.5 - 3.5 kg range i.e. 70 [50%, p=0.86]. The proportion of primi/multi parity was 60 [45%] and 23 [49%] in still birth and neonatal deaths respectively [p=0.308]. The leading causes of prematurity were antepartum hemorrhage, hypertensive disorders and chorioamnionitis. Perinatal mortality is markedly affected by fetal maturity. Parity and fetal weight have an insignificant effect on perinatal mortality

Complications and management of unsafe abortion

To determine the frequency of unsafe abortion and its morbidity and mortality in patients presenting at Civil Hospital Karachi Descriptive study. Department of Obstetrics and Gynecology, Unit III Civil Hospital Karachi, from 1st January 2001 to 31st December 2005 All patients with history of induced abortion were admitted. The particulars related to each case like age, marital status, parity, reason for requesting abortion, place and expertise of person carrying out the procedure and outcome were recorded. Once patient arrived in our unit detailed examination was done and relevant investigations sent. After primary resuscitation and optimization, the patients were managed according to their complications in collaboration with general surgical department Fifty nine mostly young ladies with age range of 17 to 47 years and mean age of 30.76 years, presented with complications of induced abortion. Fifty four patients were married and 5 were single mothers. Fourteen patients [24%] were nullipara and remaining 45 [76%] were having 5 or more children. Only 7 out of 59 patients were booked cases, who underwent elective therapeutic medical termination of pregnancy [for foetal congenital anomalies in 5 cases and maternal grade III cardiac disease in 2 cases] They had no complication. Fifty two patients presented with induced and unsafe abortion. They were referred cases, and had multiple complications. Two patiens were brought dead and one patient died during pre-operative resuscitation. Out of remaining 49 patients, five [10%] were managed conservatively, 25 [51%] had re-evacuation and 19 [39%] underwent exploratory laparotomy. Ileal perforation was found in 5 cases. These were treated by primary repair and resection and anastomosis [2 cases each] and ileostomy in 1 case. Sigmoid perforation was found in 3 cases and managed by colostomy. Repair of uterine perforation only was done in 4 cases. Hysterectomy was performed in 4 patients. In three patients peritoneal toilet was also done. Overall mortality was 9.6% [n-5] Our data shows high morbidity and mortality associated with induced unsafe abortion in the form of prolonged hospital stay, multiple blood transfusions, laparotomies, hysterectomies that compromises the obstetrical future of young patients

study of the digestive effect of dates on sucrose and starch

A study of the digestive effect of dates on sucrose and starch has been carried out. Digestion of sucrose and dates and starch and dates at pH 7.4 results in the breakdown of both sucrose and starch to glucose and fructose. On the contrary, digestion of sucrose and starch alone at pH 7.4 does not cause any breakdown suggesting that dates do affect the breakdown of sucrose and starch in the intestine. The variations in the analytical results are of the order of 1-2% in terms of RSD

Evaluation of mineral contents of some edible medicinal plants

The contents of macro-[Cd, Al, Pb, Mg, Ca, Na, K] and trace- metals [Cu, Ni, Cr, Fe, Mn] in ten edible medicinal plants have been determined by atomic absorption spectrophotometry using a wet digestion method. The overall reproducibility of the method is within

Preterm labor-still a challenge

To identify the frequency of different aetiological factors of preterm labour, and to suggest preventive measures to reduce its incidence. Prospective, descriptice study from June 2005 to Dec. 2005. Setting: Department of Gynaecology and Obstetrics [Unit III], Civil Hospital, Karachi. One hundred pregnant women having one foetus, with preterm labour [<37 weeks]. Information regarding past history, present symptoms, menstrual and obstetrical history, findings of clinical examination and investigations like haemoglobin%, total leucocyte count, platelet count, random blood sugar, urine D/R [microscopy, culture, and sensitivity], high vaginal swab [gram staining, culture and sensitivity] and ultrasound pelvis [for gestational age, amount of liquor, placental localization, placental abruption, fetal and uterine abnormalities] were recorded on a proforma and the results analyzed. Out of the 100 women with preterm labour, 50% were<25 years of age, 80% belonged to the lower socio-economic group, 70% were not booked cases, 40% were primigravida and 18% had a past history of preterm labour. Urinary tract infection was found in 32% of the cases, bacterial vaginosis in 13%, abruptio placenta in 18%, unexplai-ed antepartum haemorrhage [APH] in 2%, polyhydramnios in 5%, pregnancy induced hypertension in 4%, cervical incompetence in 2%, fetal anomalies in 2% and pulmonary Kock?s in 1% cases; in 21% cases no risk factors could be identified. Preterm labour and delivery are a major cause of perinatal morbidity and mortality, specially in the developing countries. The costs of neonatal intensive care in short term and the resources needed to support children with long-term morbidity as a result of preterm birth are considerable. Preventable and treatable causes of preterm labour should be identified and dealt with for the better maternal and foetal outcome

Is there a correlation between degree of viremia and liver histology in chronic hepatitis C?

To determine the correlation between degree of histological liver damage and serum HCV RNA level in patients of chronic hepatitis C, in order to evaluate the usefulness of HCV RNA estimation as an alternate to liver biopsy. This non-interventional descriptive study, was carried out at the department of Pathology, Army Medical College, Rawalpindi, Pakistan between April and September 2002. Core needle liver biopsies of fifty five patients of chronic hepatitis C were evaluated according to Knodell's histological activity index system. The patients were categorized into four subgroups depending upon the grade and stage of disease according to Desmet's classification, and into three groups according to degree of viremia. Five patients had mild viremia, 43 moderate and 7 had severe viremia. Seven patients had minimal disease, 9 mild, 22 moderate and 17 had severe chronic hepatitis. Eight patients had no fibrosis, 20 had fibrous portal expansion, 19 bridging fibrosis, and 8 patients had cirrhosis. No significant correlation was found between serum HCV RNA levels and grade or stage of the disease, with correlation coefficients of rs = -.054 and rs =.034 respectively. Moreover, no individual component of the HAI correlated with serum HCV RNA levels. Serum HCV RNA level does not determine the degree of hepatic injury precisely and liver biopsy is necessary to accurately evaluate the extent of liver damage

Benign schwannoma of tongue, Case report

Schwannoma is a rare tumour of the tonque. A case of benign schwannoma of the tongue is reported where in patient presented with swelling of the tongue, difficulty in swallowing and speech. It was resected through intra oral route under general anesthesia