Assessment of rifampicin resistance in re-treatment cases of pulmonary tuberculosis using gene-xpert

Objective:To assess therifampicin resistance in re-treatment cases of pulmonary tuberculosis using gene-xpert.Material and methods:This cross sectional study was conducted at Department of Pulmonology Bahawal Victoria Hospital, Bahawalpur.Total 145 patients who came for re-treatment of TB either male or female having age 20-60 years were selected for this study.Results:Mean age of the patients was 45.79 ± 11.65 years and mean duration of TB was 5.44 ± 2.9 years.Rifampicin resistance was found in 55 (38%) cases by using gene-xpert test. Rifampicin resistance is significantly associated with gender but insignificantly associated with age and duration of TB.Conclusion:In present study very high percentage of rifampicin resistance was found in retreatment cases of TB by using gen-xpert test.Significant association of gender with rifampicin resistance was noted but insignificant association of age and duration of TB with rifampicin resistance was detected.

XANTHOGRANULOMATOUS CHOLECYSTITIS: A DIAGNOSTIC DILEMMA

@#Xanthogranulomatous cholecystitis is a rare histopathological finding and accounts for 1.3% to 5.2% of cases. It closely resembles gallbladder cancer because of its extensive inflammation and involvement of the surrounding organs. We are reporting a case where it presents as an extensive inflammatory mass mimicking gallbladder cancer.

Subclinical Hypothyroidism among local adult obese population

Objective: To determine the frequency of subclinical hypothyroidism in local adult obese population

Methods: The study was conducted at Hayatabad Medical Complex, Peshawar, from March, 2017 to August, 2017. All patients aged between 18 and 60 years with BMI of more than 29kg/m[2] were included in the study. Patients on lipid lowering drugs, with renal failure, hepatic failure and already diagnosed cases of thyroid dysfunction were excluded from the study. Thyroid functions were measured for all patients

Results: A total of 127 adults were included in the study in a consecutive manner. Mean age was 34.5 + 7.9 years of which 46.5% were male and 53.5% were female. Mean BMI was 32.05 +/- 2.06 kg/m[2]. The mean serum TSH was 3.13 +/- 1.10 mIU/L and mean serum thyroxine level was 1.08 +/- 0.25 ng/dl. Subclinical hypothyroidism was recorded in 15% of the study population

Conclusion: Subclinical hypothyroidism is highly prevalent in our population with BMI of more than 29kg/m[2]. Further studies are recommended on relationship between thyroid functions and BMI and its effect on cardiovascular functions

Correlation of perfusion and contractility of left ventricle myocardium on gated myocardial perfusion scintigraphy

Gated Single Photon Emission Computerized Tomography [SPECT] is a modality which is helpful in the detection of wall motion, thickening and ejection fraction of left ventricle. The purpose of this study was to correlate the ungated and gated SPECT in evaluation of left ventricle dysfunction. It was a prospective study done at Institute of Radiotherapy and Nuclear Medicine [IRNUM], Peshawar, in 2001/02. 76 patients [47 male and 29 female] with an average age of 52 +/- 11 years were inducted in this study. All patients underwent two days stress-rest Tc-99m MIBI [Methoxy Isobutyl Isonitrile] gated SPECT scan where 1110 MBq [30 mCi] was injected intravenously. Eight frames gating technique [variable fixed temporal resolution] of ECG was used to gate the cardiac cycle and whole acquisition was completed in 30 minutes. This technique very well evaluated the perfusion as well as wall motion/thickening [W/M/T] status of left ventricle. Out of 76 scans, 30% were normal, 22% transmural infarct, 25% partial thickness infarct, and 22% reversible ischemia. By doing the 20 segmental analyses, total 1520 segments were analyzed that

evealed good concordance of perfusion with W/M/T in 78% of segments while 22% segments showed poor concordance. Out of these 22%, 12% were having more wall motion abnormalities than that of perfusion, while in 10%, it was vise versa. Results of this study shows good correlation between gated and ungated SPECT for evaluation of left ventricle dysfunction [r = 0.73, p

Clinical efficacy of diltiazem in hyperthyroidism

To evaluate the effect of diltiazem on the adrenergic manifestations of hyperthyroidism. This prospective, interventional study included newly diagnosed patients with untreated hyperthyroidism attending the out patient department of Institute of Radiotherapy and Nuclear Medicine, Peshawar. All patients took diltiazem 30 mg three times a day for 6 weeks. Clinical assessment was done before starting therapy and then serially after 1, 2, 4 and 6 weeks [+3 days] using standardized and modified hyperthyroid symptom score [HSS] including excessive sweating, trembling hands, heat intolerance, easy fatigability, nervousness, diarrhoea, increased appetite, palpitation and dyspnoea on exertion. This study was conducted on 19 patients [16 females and 3 males, mean age 35.31 +/- 10.36 years] HSS decreased from 14.42 +/- 2.71 [mean +/- SD] to 12.89 +/- 3.39 after one week [P<0.05], and then to 11.21 +/- 3.64, 10.78 +/- 3.35 and 10.26 +/- 2.95 after 2, 4 and 6 weeks, respectively [P<0.001]. Diltiazem effectively controls the clinical manifestations of hyperthyroidism