Albendazole in the treatment of hymenolepiasis in school children

Hymenolepiasis is a helminthic and occasionally fatal disease of human imposing heavy economic losses to human society. Present study was aimed to diagnose the school children for the prevalence and control of Hymenolepiasis. A school based cross-sectional analysis of stool samples collected from 188 children aged 06-15 years was carried out [February to June 2016]. Two stool samples were collected from each student before diagnosing and after treatment. The samples were fixed in 10% formalin and observed under the light microscope using the methods of direct smear in Lugol's solution, normal saline and flotation techniques. On the basis of drugs accessibility all the H. nana infected children were divided in to 2- groups. Children in group A were treated with albendazole [bendazol] 400mg once orally, group B was treated with albendazole [zentel] 200mg orally. Eggs per gram of faeces were counted in each group before and after treatment. Of the 188 children, current study reveals only 6.08% [n=18/296] infection with H.nana and 10.5% [n=16/151] were diagnosed with co infections. The % efficacy of albendazole [Zentel] and albendazole [bendazol] against Hymenolepis nana infection was reported as 83% and 75% respectively. Present study was concluded that albendazole [zentel] is the drug of choice for the treatment of hymenolepiasis in children

Comparison of analgesic efficacy of intra-articular and peri-articular sacro-iliac joint injection in patients with sacro-iliac joint pain syndrome

Objective: To compare the analgesic efficacy of intra-articular vs peri-articular sacroiliac joint [SIJ] injection in patients with sacroiliac joint pain syndrome. Study Design: Prospective, randomized control trial. Place and Duration of study: The study was conducted at the department of Pain Medicine, Combined Military Hospital [CMH] Rawalpindi, from Jul 2015 to Jun 2016

Material and Methods: Forty eight patients of sacroiliac joint [SIJ] pain syndrome were randomly assigned into two equal groups. Group A [n=24] received intra articular SIJ injection of local anesthetic with steroid [Triamcinol one 40mg] under fluoroscopic guidance [drug volume 2.5] and group B [n=24] received Periarticular SIJ injection of local anesthetic with steroid [Triamcinolone 40mg] using land mark technique [drug volume 10ml]. Pain score was assessed at 0 [Preprocedural baseline], 4, 8, and 12 week intervals after intervention by using numerical rating scale [NRS]

Results: Mean NRS pain score of group A was 7.5 +/- 0.99 and 3.1 +/- 1.6 at 0 and 12 week respectively. Mean NRS pain score of group B was 7 +/- 1.10 and 5.55 +/- 1.0 at 0 and 12 week respectively. A p-value <0.05 at 12 week between group A vs group B. There was a reduction in mean pain score from baseline to 12 week in both the groups but this reduction in mean pain score was statistically significant in group A as compared to group B

Conclusion: Pain relief score was found to be statistically significant in fluoroscopic guided intra-articular technique as compared to peri-articular landmark technique for sacroiliac joint pain syndrome at 12 weeks post procedure

Removal of foreign body impacted in rectum: a case report

An unusual case is reported here in which a smooth metal cup stuck up-side-down in the inflamed rectum of a young man for three days was successfully removed after bending the cup to dis-impact it. The patient had consulted multiple hospitals but was refused treatment. He had a lax anal sphincter but the rim of the cup was impacted into the inflamed rectal wall. Bi-valved vaginal speculum and Deaver retractor were used to dis-impact the rim on three sides. A strong artery forceps was used to twist the fourth side inwards thus freeing the edge and to slide the cup out of the anal orifice. This techruque is suitable for metallic foreign bodies with a large diameter impacted in the rectum

Assessment of diastolic function parameters with ECG gated myocardial perfusion spect: comparison of Two algorithms

Background: To compare Cedars-Sinai QGS and Michigan University Corridor4DM algorithms for determination peak filling rate [PFR], time to peak filling rate [TPFR] and mean filling rate in first third of diastole [MFR3] using 16 frames gated myocardial perfusion single photon emission computed tomography [SPECT]. To determine inter-observer reproducibility of Cedars QGS and Michigan University Corridor4DM for determination PFR, TPFR and MFR3 using 16 frames gated myocardial perfusion SPECT

Methods: Forty patients [28 males and 12 females] with age range 35-70 years [mean 58.85+/-8.82] referred for assessment of left ventricular perfusion and function were included in the study. All patients were injected 1100 Mega Becquerel [MBq] of freshly prepared [99m]Tc Sestamibi. One hour later, patients underwent gated myocardial perfusion SPECT on Siemens ecam dual head variable angle gamma camera using 16 frames per cardiac cycle. Data were reconstructed using filter back projection and re-orientated to generate short axis slices. Short axis slices were processed with QGS and Corridor 4DM for assessment of PFR, TPFR and MFR3 by two observers. Data from both observers were compared to determine inter-observer reproducibility of both methods. Observeri PFR, TPFR and MFR3 values derived from QGS and Corridor4DM were compared and correlated

Results: Peak filling rate values determined with Cedars QGS program were not significantly different from those determined with Corridor4DM [p= 0.564]. Good correlation was found between QGS and 4DM measured PFR values [R[2]=0.6698]. TPFR values determined with QGS program were not significantly different from those determined with Corridor 4DM program [p= 0.615]. However, there was poor correlation between these two methods with R[2] value =0.0382. MFR3 values determined with QGS were not statistically different from those derived from 4DM [p=0.587]. However, there was poor correlation between these values R[2]= 0.0174. Cedars QGS algorithm was highly reproducible for determination of PFR, TPFR and MFR/3 with R2 values of 0.9922, 0.9874 and 0.9932 respectively. PFR, TPFR and MFR3 derived from Corridor4DM were also highly reproducible with R[2] values of 0.7775,0.8381 and 0.456 respectively

Conclusions: Both Cedars QGS and Michigan University Corridor 4DM programs are robust for determination of PFR, TPFR and MFR3 diastolic function parameters. There is good correlation between QGS and 4DM derived PFR measurements. However, there is poor correlation between QGS and 4DM derived TPFR and MFR3 values

Etiology of short stature in children

To determine the causes of short stature in children with special emphasis on growth hormone deficiency. Case series. Department of Paediatrics, Military Hospital, Rawalpindi and Combined Military Hospital, Multan from September 2004 to January 2007. Two hundred and fourteen children [140 boys and 74 girls], ranging from 02 to 15 years presenting with short stature were studied. Height and weight were plotted on appropriate growth charts and centiles determined. Relevant hematological and biochemical investigations including thyroid profile were done. Bone age was determined in all cases. Growth hormone axis was investigated after excluding other causes. Karyotyping was done in selected cases. Data was analyzed by SPSS 10.0 by descriptive statistics. Mean values were compared using t-test. In this study, the five most common etiological factors in order of frequency were Constitutional Growth Delay [CGD], Familial Short Stature [FSS], malnutrition, coeliac disease and Growth Hormone Deficiency [GHD]. In 37.4% of patients, the study revealed normal variants of growth - CGD, FSS or combination of both, 46.7% cases had non-endocrinological and 15.9% had endocrinological etiology. CGD [22.1%] in males and FSS [27%] in females were the most common etiology. GHD was found in 6.1% children and it comprised 38.2% of all endocrinological causes. Children with height falling below 0.4[th] centile were more likely to have a pathological short stature [79.2%] compared to 39.3% whose height was below 3rd centile but above 0.4[th] centile [p<0.05]. CGD and FSS are most common causes of short stature in boys and girls respectively, whereas, GHD is a relatively uncommon etiology

Leigh disease-a rare mitochondrial neurometabolic disorder

Clinical presentation of Leigh's disease can be highly variable. We present here this case which presented with quite bizarre neurological symptoms and signs in early infancy and was suspected on the basis of CT scan findings which was further supported by high serum lactic acid levels