Anemia in children of hazara division Anemia in Children

Objectives: To determine the frequency of anemia in children of Hazara Division

Study Design: Cross-sectional / observational study

Place and Duration of Study: This study was carried out at thePediatric Outpatient of Ayub Teaching Hospital Abbottabad from 1[st] January,2015 to 30[th]June,2015

Materials and Methods: Three hundred and seventy five children were selected randomly using random number tables from Hazara Division coming to Pediatric Outpatient of Ayub Teaching Hospital Abbottabad. Their age range was 0-18 years.Their diagnoses were ascertained, recorded and analysed

Results: Majority of the patients were male and were in the age-range of 2-10 years.Anemia was present in 3.9999 % of children.Iron deficiency anemia was the most common cause of anemia in these children

Conclusions: Majority of the children were male and were in the age range of 2-10 years.Anemia was present in 3.9999% of these children and iron deficiency was the most common cause of it

Comparison of conventional pyodine dressing with honey dressing for the treatment of diabetes ulcers

To compare the conventional pyodine dressing with honey dressing in terms of recovery time and outcome [healed or ended up with amputation] in diabetic foot ulcers. This quasi-experimental study was performed in surgical "C" ward, Lady Reading Hospital Peshawar from November 2007 to November 2008. All Wegner's grade I-IV, unilateral diabetic foot ulcer patients were admitted and their blood sugar profile, cardiac and renal status were investigated. Patients were assigned to group A and B with simple convenience method. After ample wound debridement group A and B were treated with daily conventional Pyodine dressing and Honey dressing respectively and their recovery time, outcome were recorded during the 10 weeks follow up period. A total of 100 patients with 50 patients in each group A and B were enrolled in the study with mean age 56 +/- 8.0 years and male to female ratio of 1.7:1. Recovery time was significantly quicker in the Group B [Honey Dressing] as compared with the group A [conventional Pyodine dressing] with a p-valve of <0.0001. Healing rate was 69% and amputation rate was 31% as a whole. Healing rate was 66% in the Group A in comparison with 72% in the group B while amputation rates were 34% and 28% in the group A and B respectively with no statistical significance with a p-value of 0.6658. Honey dressing is more effective than conventional Pyodine dressing in terms of recovery time in the treatment of diabetic foot ulcer

Rabies neutralizing antibody level in immunosuppressed patients after receive of rabies post-exposure prophylaxis

Introduction: Rabies is a fatal disease and has a threatening risk for the public health. Immunosuppression is related to a wide variety of diseases. It is recommended that immunosuppressed patients receive the full post exposure vaccination, concerning that the immune response may be inadequate. The aim of this study is to determine the level of rabies neutralizing antibody in immunosuppressed patients after receiving rabies post-exposure prophylaxis. Consequently we assess the efficiency of antibody level in immunosuppressed patients admitted at Pasteur Institute of Iran. The study was performed at Pasteur Institute of Iran. Data related to immunosuppressed patients, doses of anti-rabies vaccine and serum, and level of rabies neutralizing antibody titer collected from the patients admitted to the Prevention and Treatment of Rabies Center, Department of Vaccination at Pasteur Institute of Iran, during 2008 to 2010. Subjects who received chemotherapy, immunosuppressive drugs, and chronic renal failure were included in this study. Results: Twenty two cases were evaluated. The Immunosuppressed state was related to cancer [in 8 cases], 4 cases of hematologic disorders, 6 cases of autoimmune disease, and 4 cases of chronic renal failure or kidney transplant. Mean age of 46.45 +/- 21.5 year. All cases received HRIG serum [human rabies immunoglobulin] plus PVRV [Purified Vero cell rabies vaccine]. The level of rabies neutralizing antibody was checked two weeks after the last dose of vaccine. Mean level of rabies neutralizing antibody was 12.07 +/- 6.72 IU/ml. All cases achieved minimum protective level of antibody which is = 0.5 IU/ml. The amount of the antibody level had no relation to age or kind of immunosuppressive disease of patients. Conclusion: It is recommended that Rabies-exposed immunosuppressed patients receive rabies post exposure prophylaxes. We have to be cautious about the cases who have not achieved the appropriate level of rabies antibody. Keywords: Post-exposure rabies prophylaxis, Immunosuppressed patients, Rabies neutralizing antibody

Mesalazine-induced eosinophilic variant of wegener's granulomatosis in an ulcerative colitis patient

A 24-year-old woman presented with two weeks history of progressive shortness of breath associated with sharp chest pain. She had been on mesalazine for two years for Ulcerative Colitis. Chest X-ray showed bilateral pulmonary infiltrates with left sided pleural effusion. Blood investigations revealed, positive pANCA, negative cANCA and peripheral eosinophillia. Video assisted thoracoscopic lung biopsy specimen was consistent with eosinophillic variant of Wegener's granulomatosis. She responded to combination of withdrawal of mesalazine and high dose steroids. To our knowledge this is the first reported case of mesalazine induced eosinophilic variant of Wegener's granulomatosis

Prevalence of cardiomyopathy in Duchenne and Becker's musculr dystrophy

Cardiac assessment was not done routinely in Duchenne [DMD] and Becker muscular dystrophy [BMD] patients in Northern region of England while evidence was gathering on progressive cardiomyopathy in these patients. We wanted to find out the prevalence, progression and clinical features of cardiac involvement in Duchenne and Becker muscular dystrophy. It is a retrospective review of clinical, electrocardiographic and echocardiographic assessments. The notes of 52 Duchenne and Becker muscular dystrophy patients were reviewed out of which 32 had DMD, 6 had Intermediate muscular dystrophy [IMD] and 14 had BMD. Prevalence of preclinical and clinically evident cardiac involvement was 88.4% in DMD and BMD patients. Sixty nine% of patients had clinically evident cardiac involvement but only four patients had cardiac symptoms in the form of palpitations, out of which two were due to respiratory dysfunction and others was due to cardiac failure. Clinical examination of the rest of all of the patients was unremarkable. Electrocardiogram was abnormal in 88.4% of patients. Conduction defects were found in 19.4% of patients. Echocardiogram was abnormal in 80.7% of patients but all were poor echo subjects including those who had normal echocardiogram. Though most patients were asymptomatic, a high percentage had evidence of preclinical and clinically evident cardiac involvement. So in all patients with Xp21 linked muscular dystrophy a routine baseline cardiac assessment should be done at the age of 10 years and reviewed after intervals of one to two years