ABSTRACT
The purpose of this study was to determine the career preferences of medical students and to identify differences between male and female medical students. These results are helpful in understanding current thinking of medical students and provision of health for all and designing future health policies of the country. Cross-sectional study. This study was conducted at Islamic International Medical College Trust [IIMCT], Rawalpindi from January 2014 to April 2014. This study was performed at Islamic International Medical College Trust [IIMCT] including 100 students from the first year and 100 students of final year MBBS. The College is a private medical school located in Rawalpindi. Inclusion criteria: All students of 1st year and final year MBBS. Exclusion criteria: Incompletely filled questionnaire excluded from the study. Socio demographic: Response rate was 92.5% with 185 questionnaires out of 200 completed and returned. Mean age of the respondents was 21.5 years, ranging between 20 and 25 years. One hundred eleven [111] [60%] respondents came from major cities, eighteen [18] [9.7%] lived abroad, whereas 21 [11.4%] came from rural or semi-urban areas of Pakistan. In our sample a large proportion of the students were females. Location of practice: Most of the students preferring to settle in an urban setting. Majority of students want to do post graduation, very few opted for general practice and one third thinking of abroad for post graduation and only a few want to locate their practice in rural areas. Medical graduates prefer clinical specializations over general practice as career. Strategies need to be planned by public and private sector and implemented to stop the brain drain and retain the medical personnel to provide effective health care for all including rural areas
ABSTRACT
The aim of our study was to compare the advantages and disadvantages of burr hole and craniotomy methods in management of brain abscess in children secondary to cyanotic congenital heart disease [CHD]. The parameters used to compare these two methods were outcome of the treatment, improvement of Glasgow coma score, CT appearance of abscess andre-operation. Retrospective study was conducted over 6 year's period. A total of thirty three [33] paediatric patients were included in this descriptive study which was carried out in the Neurosurgery Department of Foundation University Medical College Rawalpindi, Pakistan from June 2003 to May 2009. Patients having the following criteria were selected for burr hole procedure: Intracranial abscess in patients of congenital heart disease, no previous surgical intervention, Patient's history and CT brain films available. Following patients were excluded from the study; postoperative, post traumatic and fungal abscess, age more than 15 years old and abscess less than 25mm Patients having low risk of anaesthesia and absence of above mentioned risk factors were selected for craniotomy and excision. Our study results showed that patients who underwent the burr hole aspiration of abscess had a decreased mortality, shorter hospital stay, significant improved progress in neurological and radiological status as compared to craniotomy and excision group. Our study results suggested that burr hole aspiration is more efficient procedure as compared to craniotomy in terms of surgical intervention and postoperative outcome in a selected group of brain abscess in patients with CHD. It is also a cost effective procedure
ABSTRACT
To analyze etiology, clinical features, pathogens, mortality and morbidity, and modalities of treatment for ventriculo-peritoneal [VP] shunt infections. Descriptive case series. Study was carried out in the department of Neurosurgery, Foundation University Medical College Rawalpindi, from June 2003 to June 2008. The record of 5 year period was reviewed. The data were evaluated for etiology of hydrocephalus, age, clinical features, microbiological parameters, management and clinical outcome of VP shunt infections. A total of 149 patients were operated for ventriculo-peritoneal shunt. Majority [n 128 - 86%] were below the age of 5 years. Twenty-one [14%] of the operated patients were admitted with symptoms of shunt infection. Four [19%] of the infected patients had throat infection/gastroenteritis rather than shunt infection. Six [29%] patients were treated conservatively with intravenous antibiotics. Eleven [52%] of the infected patients had removal of shunt and insertion of external ventricular drain [EVD] with periodic CSF sampling and culture sensitivity [CS] and delayed shunt replacement. Five [3.3%] of VP shunt patients died with shunt infection and septicemia. Commonest causative microorganism identified were staphylococcus epidermidis, staphylococcus aureus and gram negative bacilli. The most common bacteria isolated were gram positive organisms. In cases with VP shunt infection it is essential to remove VP shunt and start systemic antibiotics
ABSTRACT
Hydatid disease is caused by infestation of larvae of Taenia echinococcus [TE]. The definite hosts of TE are various carnivores [meat eaters], and dog is the most common host. Sheep, cattle, goats and swine are common intermediate hosts. Humans are infected through faeco-oral route by the ingestion of food and milk, contaminated by dog faeces containing the ova of parasite or direct contact with dogs. Eggs lose their envelop in stomach and embryos are released, which then pass through the gut wall into the portal system and are carried to the liver where most of the larvae are entrapped and encysted. Some may reach the lungs and very rarely some may pass through the capillary filter of liver and lungs and enter into systemic circulation and reach intracranial cavity. We report a case of giant intracranial, right sided, extra axial hydatid cyst [HC] extending from right frontal region to occipital region which was removed in one piece without rupture by a procedure called hydro-dissection