Oropharyngeal, hypopharyngeal and cervical esophageal reconstruction: an experience of pedicle flaps

Objective: To review the experience of single-stage reconstruction following pharygolaryngectomy and cervical esophageal defect with pedicle flaps in a tertiary care centre

Study Design: Retrospective study

Place and Duration of Study: Jinnah Burn and Reconstructive Surgery Centre, Lahore, from June 2007 to June 2017

Methodology: All patients who underwent oropharyngeal, hypopharyngeal and cervical esophageal reconstruction with pedicled flaps were included

Results: Thirty-two reconstructions were done, of which 16 [50.0%] were supraclavicular flaps, 12 [37.5%] were pectoralis major myocutaneous flaps [PMMF] and 4 [12.5%] platysma myocutaneous flaps [PMF]. Among these, 24 [75%] were males and 8 [25%] females. The mean hospital stay was 18.75 +5.45 days. Complications were noted in 12 [37.5%], salivary fistula being the most frequent found in 6 [18.75%]. Wound dehiscence was noted in 4 [12.5%], partial flap necrosis and wound infection present in 1 [3.1%] each

Conclusion: Oropharyngeal, hypopharyngeal and cervical esophageal reconstruction with pedicle flaps is still very useful and safe to perform, associated with minimal flap and donor site complications

Neurological manifestations of primary Sjogren's syndrome [Pss]

Objective: To determine prevalence, clinical patterns and outcomes of neurological involvement in a cohort of primary sjogren's syndrome [PSS] patients presenting to a tertiary care hospital

Study Design: Observational retrospective cross-sectional case-control

study. Place and Duration of Study: This study was carried out at Neurology department of Pak Emirates Military Hospital, Rawalpindi, from May 2015 to Jun 2016

Patients and Methods: All patients fulfilling American College of Rheumatology [ACR] criteria of PSS and having neurological involvement, who were admitted in Neurology wards from May 2015 to June 2016, were included in the study. Demographic, clinical and seroimmunological data of the patients was documented

Results: A total of 26 patients with PSS had some degree of neurological involvement. Mean age was 40.50 years. [SD 14.803, min 22, max 78]. Fifteen patients were female and 11 were male. Sicca symptoms [ocular and oral dryness] were present in 38.5 Percent. Serological marker anti Ro and La were present in 76.9 Percent and 42.3 Percent respectively while both Ro and La were present in 34.6 Percent. Lip biopsy was diagnostic in 80.8 Percent and schirmer test was positive in 46.2 Percent. Refractory headache was present in 84.6 Percent. Seizures occurred in 34.6 Percent, which were focal in 23.1 Percent and generalized in 11.5 Percent. Trigeminal neuralgia was present in 26.9 Percent, multiple cranial nerve palsies in 15.4 Percent and recurrent facial nerve palsies in 11.5 Percent. Optic neuritis was seen in 19.2 Percent. Clinical presentation mimicking relapsing and remitting multiple sclerosis was seen in 30.8 Percent of patients among whom 61.5 Percent also met revised McDonald criteria for dissemination in space [DIS] on MRI and 23.1 Percent met criteria for dissemination in time. MRI brain showed cortical lesions in 42.3 Percent. Longitudinally extensive transverse myelitis involving cervical and upper thoracic cords was present in 26.9 Percent of patients

Conclusion: The diagnosis of neuro-sjogren's syndrome [NSS] can be difficult in the absence of sicca symptoms especially when neurological manifestations precede sicca symptoms by many years. This requires a high index of clinical suspicion and low threshold for investigations like lip biopsy and autoantibody profile for the diagnosis. This study highlights the need to revise the overemphasis of sicca symptoms in various current diagnostic criteria in order to improve early recognition and initiation of treatment

Extended islanded reverse sural artery flap for staged reconstruction of foot defects proximal to toes

Objective: To assess the outcome of extended delayed reverse sural artery flap for reconstruction of foot defects proximal to toes in terms of flap survival, complication and extended area

Study Design: Case series

Place and Duration of Study: Jinnah Burn and Reconstructive Surgery Centre, Lahore, from February 2015 to April 2017

Methodology: Cases who underwent delayed sural artery flap were inducted. Preoperative hand-held doppler was done to confirm the location of perforator. Two suitable perforators were chosen to raise the extended flap by crossing the proximal limit in all cases. The pedicle was kept minimum 3 cm wide and perfusion was assessed. Flap was delayed for one week and vaccum-assisted closure [VAC] dressing was applied over wound. The second surgery was performed after one week. Proximal perforator was clamped and ligated after checking adequate perfusion of flap. Flap was insetted into defect

Results: Thirty-two patients were reconstructed with delayed reverse sural artery flap. The mean age of the patients was 26.5 +12.2 years. Twenty-four [75%] patients were males and 8 [25%] were females. Twenty-two [68.7%] cases were degloving wounds after road traffic accidents [RTA], 6 [18.7%] were diabetic foot wounds, 4 [12.5%] sustained injury after falling from height and 7 [21.8%] patients had fracture of metatarsals. Twenty-eight flaps were transferred after one week delay, and only in 4 cases, flap were transferred after two weeks. All flaps survived completely. Complications of infection noted in 3 [9.3%] flaps, 3 [9.3%] flaps showed tip necrosis, 2 [6.2%] flaps undergone epidermolysis and only 2 [6.2%] showed venous congestion

Conclusion: Delayed islanded reverse sural artery perforator flap is a reliable and versatile option for resurfacing soft tissue defects of lower limb proximal to the toes with lesser complications and extended coverage area

Sealed duodenal perforation by nail ingestion in a child

Unintentional foreign body ingestion is common among children. Normally, these ingested foreign bodies pass spontaneously and the rest can be removed endoscopically; only few ingested foreign bodies lead to complications and need surgical intervention. We are reporting a case of accidental nail ingestion in a 10-year-old child which led to a sealed perforation of duodenum. Operative management included primary duodenal repair after removal of nail. Post operative recovery was smooth and oral was started on day 5. We recommend that all ingested sharp and large foreign bodies should be removed endoscopically, if not passed spontaneously

Androgen deprivation therapy and cardiovascular risk in patients with prostate cancer

Objective: The objective of this study was to investigate the effects of androgen deprivation therapy [ADT] on risk of subsequent cardiovascular morbidity in men with prostate cancer

Study Design: Quasi experimental study

Place and Duration of Study: Department of oncology Combined Military Hospital Rawalpindi, from Sep 2014 to May 2015

Patients and Methods: Thirty consecutive patients fulfilling inclusion criteria were enrolled. All patients were subjected to medical castration/ androgen deprivation therapy [ADT] with monthly 3.75 mg leuprorelin acetate intramuscular injection until castrate levels of testosterone [<50ng/dL] were achieved. We used Framingham's score for assessment of 10 years cardiovascular risk of individual patient before initiation and after completion of 6 months ADT. Serum lipid profile [fasting], systolic blood pressure, history of smoking, diabetes and antihypertensive medication were recorded. Proforma was designed to get clinical information. A p-value of <0.05 was considered significant. A paired-samples t-test was conducted to compare Framingham cardiovascular risk scores before initiation and after completion of 6 months ADT

Results: We enrolled 30 men with high/intermediate risk localized prostate cancer. Mean age was 63.47 +/- 7.32 years. All patients received 6 months ADT with monthly 3.75mg leuprorelin acetate intramuscular injection. There was a significant difference in Framingham cardiovascular risk scores before [mean +/- sd; 20.95 +/- 7.98] and after [mean +/- sd; 25.72 +/- 6.15] 6 months ADT; t [29] =-4.54, p<0.01, two-tailed. Hence ADT resulted in a significant increase [mean +/- sd; 25.7 +/- 6.15] in 10 years cardiovascular morbidity risk t [29] =-4.54, p<0.01, twotailed. Subset analyses revealed significant increase in fasting serum total cholesterol, triglycerides and Lowdensity lipoprotein [LDL] levels after 6 months ADT [p<0.01, <0.01 and <0.01 respectively] however high density lipoprotein [HDL] remained un-changed [p=0.043] in comparison to pre-ADT values

Conclusion: Androgen deprivation therapy results in significantly increased risk of cardiovascular morbidity in patients with prostate cancer however this relationship between ADT and risk of cardiovascular morbidity may be confounded by unmeasured variables like obesity, atherosclerosis and body mass index [BMI] variations

Quantification and further refinements of dorsal metacarpal artery perforator flap for reconstruction of wounds of fingers up to distal interphalangeal joints

Objective: to assess the outcome of dorsal metacarpal artery perforator flap for coverage of finger defects extending up to distal interphalangeal joint [DIPJ]

Study Design: case series

Place and Duration of Study: Jinnah Burn and Reconstructive Surgery Centre, Lahore, from March 2015 to May 2017

Methodology: our study was carried out in two parts. 1st part of study was to measure average flap length in our population. Five hundred cases were enrolled to measure flap length, from pivot point of the flap to the distal border of extensor retinaculum. This length was traced to fingers to determine its coverage area. This was followed by clinical study in 35 cases. All patients with wounds over dorsal surface of fingers up to distal interphalangeal joint and volar surface of fingers up to mid of middle phalanx, single or multiple finger defects with exposed tendon joints or bones were included in the study. Patients with history of trauma to the dorsum of hand, metacarpal head or neck fracture and patients with history of diabetes or peripheral vascular disease were excluded

Results: flap length decreased from radial to ulnar side of hand. Average length of flap based on the second metacarpal artery was 7cm while of the third was 6.6 cm and the fourth was 6.1 cm. This flap length covered up to mid of middle phalanx in border digits while up to PIPJ in central digits. This data was confirmed in 35 patients in whom 36 flaps were raised to cover finger defects. Thirty-four flaps survived completely while tip necrosis was seen in 2 cases

Conclusion: the dorsal metacarpal artery perforator flap is a thin, pliable flap, which has minimal donor-site morbidity. It can reliably cover soft tissue defects of dorsum of fingers up to mid of middle phalanx in border digits and up to PIPJ in central digits

Perceptions of post-graduate residents regarding clinical educational environment by using the post graduate hospital education environment measure [PHEEM] inventory

Objective: To evaluate the post graduate residents' perceptions about the clinical educational environment during their post graduate training by using postgraduate hospital education environment measure [PHEEM] inventory

Study Design: Cross-sectional descriptive study

Place and Duration of Study: The study was conducted at Army Medical College, from Feb 2016 to Jun 2016

Material and Methods: The English version of PHEEM inventory [40 items on a 0-4 Likert scale] was distributed to 105 post graduate residents of multiple specialities by convenience non- probability sampling technique. This valid and reliable inventory is divided into three subscales of the hospital clinical educational learning environment; perceptions of teaching, perceptions of role autonomy and perceptions of social support. The perceptions of teaching, role autonomy and social support subscales contain 15, 14 and 11 items with a maximum score of 60, 56 and 44 respectively. The total summations of all these scores of three domains have a combined maximum and minimum of 160 and zero respectively

Results: The overall PHEEM score was 103.29 +/- 12.75 out of a 160 maximum score. The subscale perceptions of role autonomy, teaching and social support score were 36.11 +/- 4.15 / 56, 39.02 +/- 5.76 / 60 and 28.16 +/- 4.71 / 44 respectively

Conclusion: The residents as a whole group perceived the clinical training environment of Military Hospital Rawalpindi and Combined Military Hospital Rawalpindi more conducive however there are still few areas having room for improvement

Pattern of adult limbs fractures at Shaikh Zayed hospital, Lahore

Road traffic accidents leading to musculoskeletal injuries are increasing in trauma centers and becoming public health emergency. Experties of commonly presenting fractures pattern will help in planning and management of these injuries. This study done at Accident and Emergency Department, Shaikh Zayed Hospital, Lahore, was aimed at different fracture pattern of musculoskeletal injuries in 1 year period from February 2013 to January 2014 a total 1090 patients with Road Traffic Injuries were included in the study. 1840 adult patients who presented to the Accident and Emergency Department, Shaikh Zayed Hospital Lahore, 1090 [59.23%] of patients were due to Road Traffic Injuries. Amongst the Road Traffic Accidents [RTA] 853 [78.23%] of the patients had accidents of Motorbike QingQui Rikshaw and 897 [82.28%] of the patients were from 16-45 years age group. Highest frequency of fracture occurred in the Femur 368[33.76%], followed by Tibia/Fibula 260 [23.85%], Humerus 178 [16.33%] and Radius/Ulna 146 [13.39%]. out of 1090 fractures, Complete fractures were 1005 [92.20%]. Leading Fractures were Transverse 632 [57.98%] followed by Oblique 208 [19.08%] and then comminuted Fractures 175 [16.05%]. Causes were Road Traffic Injuries followed by Fall and Machine injuries

Postoperative analgesia; comparison of caudal bupivacaine and bupivacaine - tramadol in children with inguinal hernia repair

To compare the effects after caudal bupivacaine alone and bupivacaine-tramadol in young children with inguinal hernia repair. Department of Paediatric Anaesthesia, Children Hospital Complex, Multan. August 2008 to May 2009. A total of 100 children aged between 2-5 years were included in the study. The duration of analgesia was significantly prolonged in group-A patients [P= 0.001]. A low frequency of postoperative vomiting was observed in both groups i.e. 10% in group-A and 6.7% in group-B [P=0.64]. No respiratory depression, flushing and pruritis were observed. Low dose combination of bypivacaine and tramadol, when administered caudally, had an additive effect and provided prolonged and effective postoperative analgesia with minimal side effects

Left intra-ventricular metastasis from squamous cell carcinoma of the bronchus-case report

Lung cancer is one of the common causes for cardiac metastasis, followed by mesothelioma, melanoma, renal cell carcinoma and colorectal cancers. High index of suspicion and sound clinical Echocardiography skills is the key in detection of these metastases. Echocardiography and MRI are helpful in detection of neoplastic cardiac disease in addition to CT scan. Early detection may result in successful outcome

Gastro-oesophagectomy with two field lymphadenectomy- an optimal treatment for resectible carcinoma of the oesophagus and gastric cardia

Background: The aim of the study was to examine the outcome of surgical treatment for carcinoma of the oesophagus and gastric cardia with two-field lymph node dissection at a high volume centre by a single surgeon over 7 years period

Methods: From January 1992 to March 1999, 316 patients underwent oesophagectomy with two field lymph node clearance for cancer of the oesophagus at our unit by a single consultant surgeon. Once the data collection at the base hospital was complete, it was sent to The Cancer Intelligence Unit Information Centre at Bristol for verification of data. The data analysis was then undertaken using SPSSv9. The main technique utilized was the Kaplan-Meier survival estimate. Kaplan-Meier survival functions were produced and compared, using the log rank test, for a number of pre-specified variables and their associated levels. Multivariate analysis was performed using Cox's proportional hazards modeling

Results: The average age at the time of surgery was 63.5 years, with a male to female ratio of 2:1. 86% of patients had dysphagia at the time of presentation. 88%[277] Patients had Ivor Lewis oesophagectomy, while 6%[20] had McKeown`s and 1%[4] had left thoracolaparotomy. 5% [14] of the patients underwent total laryngo-pharyngo-oesophagectomy. In total 62% [197] of patients had adenocarcinoma and 31% [99] had squamous cell carcinoma. 68% [215] of patients had lymph node metastasis while 32% [101] had no lymphatic involvement at resection. 80% had pyloroplasty or pyloromyotomy. 8% had anastomotic leak. 30-day mortality was 7%. Overall 5-year survival was 33%, with a very significant survival difference between lymph node negative and positive patients [25%vs 49%; p<0.01]. There was no statistically significant difference in survival on the basis of gender [p=0.47], histology [p=0.48] or age [p=0.299]. In total 72 patients received adjuvant treatment and had significant survival benefit [p=0.002] but because of selection bias the results are of doubtful significance

Conclusion: It is concluded that for tumours of lower 1/2 of oesophagus Ivor Lewis oesophagectomy with two-field lymphadenectomy is safe and effective procedure. It can be performed with low morbidity and mortality and good long-term survival. Oesophageal cancer still remains a disease of old age and that on the basis of age alone no one should be denied the opportunity of surgical resection. Gastric outlet drainage had a strong influence on the incidence of postoperative leak

Rubber band ligation vs injection sclerotherapy in office management of 1st and 2nd degree hemorrhoids

To compare the effectiveness and complications of Rubber Band Ligation [RBL] with Injection Sclerotherapy [IST] in the treatment of 1st degree and 2nd degree hemorrhoids. Randomized Controlled Trial. CMH Rawalpindi, from 1st Feb to 30 Sep 2007. A total of 120 patients were selected for study. 60 patients with 1st degree haemorrhoids were placed in group I and 60 patients with 2nd degree haemorrhoids were placed in group II. These patients were then randomly divided into two sub-groups 'A' and 'B' through Random Allocation by Table of Random Numbers. Group 'IA' had 30 patients of 1st degree haemorrhoids and group 'IIA' had 30 patients of 2nd degree haemorrhoids. Similarly group 'IB' had 30 patients of 1st degree haemorrhoids and group 'IIB' had 30 patients of 2nd degree haemorrhoids. Then groups 'IA' and 'IIA' were subjected to RBL and Groups 'IB' and 'IIB' were subjected to IST. The outcome measures were relief of symptoms, recurrence rate and complications. Male to female ratio was 11:1. Among patients subjected to RBL, 58.3% were from age group 2 [31-50 yrs] with mean age 42.90 +/- 11.74 yrs and mean duration of symptoms was 6.24 + 4.91 months. Among patients subjected to IST, 55% were from age group 2 [31-50 yrs] with mean age 45.62 +/- 12.49 yrs and mean duration of symptoms was 7.03 + 4.76 months. Important immediate complication was pain, but majority of patient were pain free. In group IA 36.7% patients had slippage of ligature but none of the patients undergoing IST developed Prostatitis. Visible bleeding was the main complication in group 'IA' 4th week [p < 0.05]. Response to IST among 1st degree haemorrhoids was significant at 4th week i.e. 90%, as compared to RBL, i.e. 63.3% [p <0.05]. IST is treatment of choice for 1st degree haemorrhoids, but for 2nd degree haemorrhoids, both RBL and IST are equally effective

Psuedoaneurysm of the right hepatic artery: a rare cause of obscure GI bleeding

A 63 years old female with 1 month history of hematemesis and malena, severe weakness and lethargy, for which she had upper GI endoscopies multiple times, but the source of bleeding could not be identified. Base line investigations revealed Hb of 6.0g/dl. CT scan abdomen showed cholelithiasis with air inside the gallbladder. The selective celiac axis / Hepatic artery angiogram revealed a right hepatic artery aneurysm [pseudoaneurysm]. After resuscitation with blood transfusion and fluids, the patient under went surgical exploration, revealing an aberrant right hepatic artery aneurysm bleeding inside the gall bladder with a cholecystodeudenal fistula [Mirrizi type III] into the 1st part of the deudenum form where the blood was leaking into the gastrointestinal tract and causing severe hematemesis and malena. A cholecystectomy, dissection of sleeve of liver bed, ligation of the aneurysmal bleeding vessel, repair of the cholecystodendenal fistula and placement of the T-Tube done. Post operative the patient remained stable and was discharged on 7th post operative day. Biopsy revealed acute on chronic cholecystitis and cholelithiasis. Biopsy of the aneurysmal wall revealed inflamed granulation tissue

Sustaining soil productivity by integrated plant nutrient management in wheat based cropping system under rainfed conditions

The study of the use of organic [FYM] and inorganic [NPK] nutrient sources with biofertiliser on wheat-fallow and wheat-maize cropping system under rainfed environment revealed significant increase in biometric parameters of wheat during winter and summer seasons of two years. During both the seasons, application of 1/2 NPK + 1/2 FYM + Biopower [brand] produced the highest grain yield [3684 kg/ha] and [3781 kg/ha] of wheat with the maximum N uptake of 357 kg/ha, P uptake of 51 kg/ha and K uptake of 215 kg/ha. Wheat-maize cropping system was found to be profitable economically with integrated use of mineral and organic and/or Biopower under rainfed conditions of Pakistan

Pattern of indications of flexible bronchoscopy among adult patients in a tertiary care hospital

Background: Flexible fiber optic bronchoscopy is frequently performed procedure in pulmonary medicine

Objective: To determine the Clinico-radiological indications of flexible bronchoscopy in a tertiary care hospital

Materials and Methods: This descriptive study was conducted in the bronchoscopy suit of pulmonology department post graduate medical institute[PGMI], Lady Reading Hospital, Peshawar from Jan 2008 to Dec 2010. This was a retrospective analysis of the well maintained records of patients in whom bronchoscopy was done in the above mentioned duration. All the patients above 15 years were included. All the bronchoscopies were done by expert brochoscopists under local aneasthesia. Data was analyzed by SPSS 13 to find the frequencies and percentages

Results: Total number of patients were 423, with a male to female ratio of 1.6:1, in which 191 had haemoptysis , 115 presented with chronic cough, 42 had shortness of breath [SOB] , 11 presented as superior venacaval [SVC] obstruction, 25 had lobar or full lung collapse on chest x rays and 9 patients had solitary or multiple nodules, 8 were scoped for removal of foreign bodies, 4 for medical fitness and 2 for persisted fever. After analysis of x-rays of proven malignancies out of 60 patients, 20 [33.33%] had right side non-resolving consolidation, 18 [30%] Left side consolidation,08 [13.4%] presented with hilar mass, 03 [5%] with multiple nodules, 04 [6.66%] with mediastinal widening , 03 [5%], with left sided lobar collapse, 02 [3.33%] with right lobar Collapse and 02 [3.33%] had either side full lung collapse

Conclusion: Bronchoscopy is an important tool for the diagnosis of the cause of radiological/clinical findings like haemoptysis, chronic cough, SOB, SVC obstruction, hoarseness of voice and persistent x-ray opacity, or lobar or lung collapse. Heamoptysis and chronic cough are the main indications in our setting. Bronchoscopy is minimally invasive procedure with high diagnostic yield for bronchogenic tumours especially central

comparison of pressor respons following laryngeai mask airway vs laryngoscopy and endotracheal tube inserition

To test the hypothesis that laryngeal mask airway [LMA] insertion is associated with less pressor response as Compared to endotracheal intubation. A prospective, comparative study. Department of Anaesthesiology Intensive Care and Path Management, Nishtar Medical Institution Multan [Pakistan] from July 2007 to January 2008. 60 adult, ASA grades land II patients undergoing elective general surgery of less than one hour duration were divided in two groups with 30 patients in each. These patients were operated under general anaesthesia and either endotracheal tube [Group I] or LMA [Group II] was used to maintain the airway. The rise in heart rate, systolic and diastolic blood pressure was recorded before induction of anaesthesia and at one, three, five and ten minutes after insertion of laryngeal mask airway or tracheal tube and the results compared in both groups. A statistically significant rise in heart rate, systolic blood pressure and diastolic blood pressure was seen in group-I while statistically significant rise in heart rate only was seen in group-II subsequent to their insertion. Mean maximum increase was statistically more after laryngoscopy and endotracheal intubation than after laryngeal mask airway insertion. The duration of pressor responses was also longer after endotracheal intubation. Laryngeal mask airway is an acceptable alternative techinque offering advantages in terms of haemodynamic stability compared to tracheal intubation

Comparison of 0.5% lignocaine vs 0.5% lignocaine plus 0.25% tramadol in intravenous regional anaesthesia

To compare the quality, onset and duration of intravenous regional anaesthesia [IVRA] with 0.5% lignocaine plus tramadol and 0.5% lignocaine alone. A comparative, double blind, randomized, prospective study. Orthopaedic operating rooms, Nishtar Medical Institution, Multan, Pakistan, from June 2005 to June 2006. In our of 60 adult ASA class I and II patients undergoing upper limb surgeries in patients were divided in two groups having 30 patients in each. We used tramadol, a weak opioid as a component of IVRA with lignocaine to suppress intra-operative pain and enhance postoperative analgesia. Patients received IVRA with 40ml of 0.5% lignocaine to which either 100mg tramadol or saline was added. The onset of anaesthesia and recovery was compared by loss and regain of sensations. Tramadol with lignocaine was found to be significantly better for rapid onset and quality of anaesthesia compared to lignocaine alone and devoid of opioid related side effects. We conclude that tramadol as a component of IVRA is significantly better adjunct to lignocaine

Vacuum assisted closure of laparostomy wounds a novel technique

Management of a laparostomy wound is contentious. Specific pathologies like severe intraabdominal sepsis, trauma requiring damage control, abdominal compartment syndrome, staged abdominal repair and other complex abdominal pathologies can be managed with a novel technique of Vacuum Assisted Closure dressing. This device applies sub-atmospheric pressure that leads to reduced bowel wall edema, bacterial count and inflammatory burden found in open abdominal wounds. This leads to a reduced need for frequent dressing changes, maintaining intact skin and improvement in fluid management. Controlled clinical studies are needed to establish the safety and effectiveness of this treatment strategy. We present our experience with this technique suggesting it to be safe and effective. A brief outline of the working of Vacuum Assisted Closure dressing is also presented

Seroprevalence of HBsAg and HCV antibodies in hospital workers compared to aged matched healthy blood donors

As study was planned to document the seroprevalence of HBsAg and HCV antibodies in hospital workers compared to age-matched volunteer healthy blood donors. The study was conducted at PNS Shifa Hospital Karachi from November 2001 to October 2003. Study group comprised of 305 voluntary hospital workers including 60 doctors, 101 female nurses and attendants, 116 male nurses and attendants and 18 sweepers. Control group comprised of 300 aged matched volunteer blood donors, 90 males and 30 females. A performa was designed to record various findings. Sera of subjects were tested by a standard method for the presence of HBsAg and HCV antibodies. Study group comprised 70 [23%] doctors, 60 males and 10 females. HBsAg was positive in 1[1.43%] and HCV antibodies in 2[2.85%]. Among 101[33%] of the female nurses and attendants, HBsAg was positive in 03 [3%] and HCV antibodies in 8[8%]. Among 116 [38%] male nurses and attendants, 04 [3.44%] were HBsAg positive and 07 [6.03%] HCV antibodies positive. Among 18[6%] khakrobs and sweepers 1[5.56%] was HBsAg positive and 2[11.11%] were HCV antibodies positive. In total 10[3.27%] hospital workers were found positive for HBsAg and 18 [5.90%] positive for HCV antibodies. In voluntary blood donors, HBsAg was detected in 2.4% and HCV antibodies in 3.2%. It is conduced that the seroprevalence of HBsAg is marginally higher in hospital workers while seroprevalence of HCV antibodies is reasonably higher in hospital workers compared to general healthy population