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Aims: IMPROVE Brady assessed whether a process improvement intervention could increase adoption of guideline-based therapy in sinus node dysfunction (SND) patients. Methods: /Results: IMPROVE Brady was a sequential, prospective, quality improvement initiative conducted in India and Bangladesh. Patients with symptomatic bradycardia were enrolled. In Phase I, physicians assessed and treated patients per standard care. Phase II began after implementing educational materials for physicians and patients. Primary objectives were to evaluate the impact of the intervention on SND diagnosis and pacemaker (PPM) implant. SF-12 quality of life (QoL) and Zarit burden surveys were collected pre- and post-PPM implant. A total of 978 patients were enrolled (57.7 ± 14.8 years, 75% male), 508 in Phase I and 470 in Phase II. The diagnosis of SND and implantation of PPM increased significantly from Phase I to Phase II (72% vs. 87%, P < 0.001 and 17% vs. 32%, P < 0.001, respectively). Pacemaker implantation was not feasible in 41% of patients due to insurance/cost barriers which was unaltered by the intervention. Both patient QoL and caregiver burden improved at 6-months post-PPM implant (P < 0.001). Conclusions: A process improvement initiative conducted at centers across India and Bangladesh significantly increased the diagnosis of SND and subsequent treatment with PPM therapy despite the socio-economic constraints.
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Background and Objectives@#There is growing interest in the use of the Level-specific (LS) CE-Chirp® stimulus in auditory brainstem response (ABR) due to its ability to produce prominent ABR waves with robust amplitudes. There are no known studies that investigate the test-retest reliability of the ABR to the LS CE-Chirp® stimulus. The present study aims to investigate the test-retest reliability of the ABR to the LS CE-Chirp® stimulus and compare its reliability with the ABR to standard click stimulus at multiple intensity levels in normal-hearing adults. @*Subjects and Methods@#Eleven normal-hearing adults participated. The ABR test was repeated twice in the same clinical session and conducted again in another session. The ABR was acquired using both the click and LS CE-Chirp® stimuli at 4 presentation levels (80, 60, 40, and 20 dBnHL). Only the right ear was tested using the ipsilateral electrode montage. The reliability of the ABR findings (amplitudes and latencies) to the click and LS CE-Chirp® stimuli within the same clinical session and between the two clinical sessions was calculated using an intra-class correlation coefficient analysis (ICC). @*Results@#The results showed a significant correlation of the ABR findings (amplitude and latencies) to both stimuli within the same session and between the clinical sessions. The ICC values ranged from moderate to excellent. @*Conclusions@#The ABR results from both the LS CE-Chirp® and click stimuli were consistent and reliable over the two clinical sessions suggesting that both stimuli can be used for neurological diagnoses with the same reliability.
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@#Adolescence stage is filled with enormous changes and challenges. At this stage, adolescents are not mentally mature so they failed to adjust to the changes of their life and are at greater risk of developing smoking habit. Many psychosocial factors contribute to adolescents’ smoking, among them family role is prominent. So, the present correlational study aimed to highlight the familial predictors of smoking in adolescents. It was hypothesized that parenting styles, lack of parent-child communication, less parental monitoring, parents and sibling smoking would be related to adolescents smoking. Data was collected from 150 adolescents (smokers: 70, non-smokers: 80) throughconvenient sampling technique. Parental bonding instrument and parental monitoring questionnaire were used. Binary Logistic regression revealed less Parental care and father’s monitoring, lack of mother-child communication and siblings’ smoking as significant predictors of smoking. The study implications are discussed with its application in health, social and counseling psychology.
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Hollow-fiber liquid-phase microextraction (HF-LPME) and electromembrane extraction (EME) are miniaturized extraction techniques, and have been coupled with various analytical instruments for trace analysis of heavy metals, drugs and other organic compounds, in recent years. HF-LPME and EME provide high selectivity, efficient sample cleanup and enrichment, and reduce the consumption of organic sol-vents to a few micro-liters per sample. HF-LPME and EME are compatible with different analytical in-struments for chromatography, electrophoresis, atomic spectroscopy, mass spectrometry, and electrochemical detection. HF-LPME and EME have gained significant popularity during the recent years. This review focuses on hollow fiber based techniques (especially HF-LPME and EME) of heavy metals and pharmaceuticals (published 2017 to May 2019), and their combinations with atomic spectroscopy, UV-VIS spectrophotometry, high performance liquid chromatography, gas chromatography, capillary elec-trophoresis, and voltammetry.
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Background: Coronary Heart Disease (CHD) is the most common category of the heart disease and is found to be the single most important cause that leads to premature death in the developed world. Recognizing a patient with ACS is important because the diagnosis triggers both triage and management. cTnI is 100% tissue-specific for the myocardium and it has shown itself as a very sensitive and specific marker for AMI. Ventricular function is the best predictor of death after an ACS. It serves as a marker of myocardial damage and provides information on systolic function as well as diagnosis and prognosis. The study aimed at investigating the impact of LVEF on elevated troponin-I level in patients with first attack of NSTEMI.Methods: This cross-sectional analytical study was conducted in the department of cardiology in Mymensingh Medical College Hospital from December, 2015 to November, 2016. Total 130 first attack of NSTEMI patients were included considering inclusion and exclusion criteria. The sample population was divided into two groups: Group-I: Patients with first attack of NSTEMI with LVEF: ≥55%. Group-II: Patients with first attack of NSTEMI with LVEF: <55%. Then LVEF and troponin-I levels were correlated using Pearson’s correlation coefficient test.Results: In this study mean troponin-I of group-I and group-II were 5.53±7.43 and 16.46±15.79ng/ml respectively. It was statistically significant (p<0.05). The mean LVEF value of groups were 65.31±10.30% and 40.17±4.62% respectively. It was statistically significant (p<0.05). The echocardiography showed that patients with high troponin-I level had low LVEF and patients with low troponin-I level had preserved LVEF. Analysis showed that patients with highest level of troponin-I had severe left ventricular systolic dysfunction (LVEF <35%) and vice versa-the patients with the lowest levels of troponin-I had preserved systolic function (LVEF ≥55%). In our study, it also showed that the levels of troponin-I had negative correlation with LVEF levels with medium strength of association (r= -0.5394, p=0.001). Our study also discovered that Troponin-I level ≥6.6ng/ml is a very sensitive and specific marker for LV systolic dysfunction.Conclusions: The study has enabled the research team to conclude that the higher is the Troponin-I level the lower is the LVEF level and thus more severe is the LV systolic dysfunction in first attack of NSTEMI patients.
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Iran bears a remarkable variety of reptiles. One of the lizard families occurring in Iran is the Family Agamidae which is widely are distributed throughout the old world. The large-scaled rock agamid, Laudakia nupta, is one of the well-known agamid. There are few reports of cloacal microbial on reptiles hence their function in cloacae remains unknown. Laudakia nupta usually live in rural and urban areas and close vicinity to man, they are likely to play an important role in the spread of disease that may be caused by these microorganisms and their transmission to man. Therefore, the aim of this study was to identify the bacterial flora colonizing the cloacal region of Laudakia nupta using molecular studies. The cloacal fluids were directly placed on nutrient agar (NA) plates and incubated at 25 ± 2 ℃ for 48 h. The resulting bacterial colonies were transferred to fresh nutrient agar (NA) plates for molecular studies. Twelve isolates were obtained from 17 specimens of Laudakia nupta. All bacteria isolates were identified as Bacillus subtillis (5), Bacillus cereus (4), Bacillus sp. (1), Pseudomonas putida (1), and Pseudomonas sp. (1) based on partial sequences of the 16 s rRNA gene. This is the first comprehensive report of bacteria spp. associated with cloaca of Laudakia nupta using molecular studies. In this research, we found that Laudakia nupta can be a carrier of bacteria which can transfer microorganisms to hosts.
Subject(s)
Humans , Agar , Bacillus , Bacillus cereus , Bacteria , Cloaca , Colon , Genes, rRNA , Iran , Lizards , Pseudomonas , Pseudomonas putida , ReptilesABSTRACT
A renal artery pseudoaneurysm is a rare but important complication that can occur after renal trauma, renal biopsy, percutaneous nephrostomy, percutaneous nephrolithotomy [PCNL], and partial nephrectomy. The incidence of this potentially life-threatening complication is less than 1%, but is likely to increase with the increasing popularity of endoscopic renal procedures. We present a case of a 30-year female who underwent right PCNL for a right renal pelvic stone. Two weeks later, she presented with massive hematuria. Renal angiography revealed psuedoanurysm of interlobar artery which was successfully treated with coil embolization
Subject(s)
Humans , Female , Adult , Nephrolithotomy, Percutaneous/adverse effects , Renal Artery , Aneurysm, False/etiology , Kidney CalculiABSTRACT
Excluding all third molars, the most common impaction is of maxillary canine. Palatal impaction [80%] is much more common than labial impaction [20%]. Impaction of maxillary central incisor does not occur frequently. We report an 11-year girl with clinical and radiological features of impacted maxillary canine and maxillary left central incisor. At the age of five years, she had a fell victim to history of trauma of maxillary central incisor with premature exfoliation. Radiograph showed labial impaction of right canine and left central incisor in maxilla
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Objective: The objective of this study was to determine in vitro MIC patterns of various therapeutic alternatives for the treatment of Salmonella Paratyphi A. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Pathology Rawalpindi, from Jun 2012 to May 2014
Material and Methods: Clinical samples were collected from suspected cases of salmonella infections. Culture was applied on Bactec 9050 special and/or standard media. Suspected Salmonella Paratyphi colonies were tested by API 20E and confirmed by serology. The isolates were also tested for resistance to ampicillin, cotrimoxazole, ciprofloxacin, ceftriaxone, doripenem, imipenem, ertapenem, aztreonam, moxifloxacin, cefpirome, cefepime, gatifloxacin, and chloramphenicol by Kirby-Bauer disc diffusion method. MIC [Minimum Inhibitory concentration] was done on MDR and ciprofloxacin intermediate or resistant cases by E-strips
Results: One hundred and eleven isolates of Salmonella Paratyphi were recovered from 2230 specimens. Resistance by disk diffusion technique noted in Salmonella Paratyphi A was ampicillin 60%, chloramphenicol 40%, cotrimoxazole 38%, ceftriaxone 7.9%, ciprofloxacin 8%, cefpodoxime 7.9%, imipenem and ertapenem 2.6%, aztreonam 1.3%, moxifloxacin 6.6%, and gatifloxacin 1.3%. No resistance was noted for doripenem and cefepime. MIC50 was 0.094 for Cefpirome, 0.125 Aztreonam, 0.25 imipenem and tigecycline, 2 cefpodoxime and 8 for azithromycin
Conclusion: Azithromycin, Aztreonam, Imipenem, tygecycline, cefpodoxime and cefpirome are potential therapeutic agents for resistant Salmonella Paratyphi A infections
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Objectives: The objectives of my study were to identify major factors which prevent mothers to breastfeed their infants in the first six months and to analyze the behavioral constraints to develop a suitable strategy for strengthening the practices of exclusive breastfeeding
Study Design: Descriptive Study
Methodology: The study was conducted on 37 subjects, who were mothers with young children under six months of age and were not breastfeeding their children due to any reason. The study was based on direct interview taken at DHQ Hospital Kasur and BHU Rao Khan Wala in the district Kasur. The interviews lasted for about half an hour with each subject. Subjects who were breastfeeding regularly or who were HIV, Hepatitis and other diseases positive were not included. The interviews were conducted in a separate room with least disturbance. Quantitative data like age was presented by mean and standard deviation while qualitative data education, profession were presented by frequency and percentages. SPSS [version 20] software was used for data analysis
Results: The mean age of infants of group [62.1%] was of 2.2 months ± 0.7 and other group of infants [37.9%] was of mean age 5.2 months +/- 0.6. The mean weight [kg] and standard deviation of the index children at birth was 3.1 [kg] +/- 0.2. Among index infants 37.8% were male infants and 62.2% were female infants. By place of birth of children, 75.6% births took place in a health facility. 32.4% mothers were illiterate. 13.5% mothers were on job. Only 83.7% females had fed colostrum to their infants. 62.1% mothers were those who never fed their infants. 27.0% were those who initially fed their infants for short period of time and then stopped feeding who fed irregularly was 10.8%. Important factor identified was insufficient milk production [65.2%] with significance of p-value = <0.05 and Sickness of mothers and consequently advised by doctor to avoid breastfeeding to their infants, was contributing [52.1%] with significance value p= <0.05 among mothers who never breastfed their infants under six months of age
Conclusion: Inadequate milk production and mothers' sickness were most commonly stated factors
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Objective: To identify the phenotype and genotype of hypodontia for a Pakistani family with hypodontia and to map the genes locus responsible for this disease
Study Design: Descriptive study
Place and Duration of Study: This descriptive study was performing in human molecular genetics [HMG] laboratory of Baluchistan University of information technology, engineering and management sciences [BUITEMS]. The study was of 4 months duration
Material and Methods: Blood samples [5ml] were collected from all 15 families' members [35participant]. Genomic DNA was extracted by using inorganic method. All the three coding exons of PAX9 [NM_006194] were amplified and sequenced. Sequencing of the PAX9 coding exons and splice sites showed a homozygous misses substitution in exon 3 [c. 718G>C; p.Ala240Pro] in the affected individuals of the family
Results: Intra-oral and panoramic radiographs revealed that the proband [II-1] and her father [I-1] have hypodontia denoted by the complete absence of teeth in maxillary arch, while all other family members maintained normal dentitions. The missing teeth are both upper lateral incisors [12, 22 FDI numbering] and third molars [18, 28]. Mandibular arch show; retained deciduous teeth and no teeth permanent teeth missing. Pedigree construction indicated that phenotypes in this family showed an autosomal recessive segregation pattern. The sequencing of coding exons and splice sites of PAX9 gene showed a homozygous missense mutation in exon number 3 [c. 718G>C; p.Ala240Pro] in the affected individuals of the family
Conclusion: We identified a missense mutation [p.Ala240Pro] in gene PAX9 coding exon 3 in Pakistani family with hypodontia
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Objective: To compare the intravenous Labetalol versus intravenous hydralazine in patients having severe Pregnancy induced hypertension [PIH] and pre eclampsia [PE] in pregnancy
Methods: Seventy eight women admitted in the Department of Gynecology and Obstetrics, Civil Hospital Karachi, having severe PIH/PE and fulfilling the inclusion criteria were included in the study. Random selection of patients was performed using sealed opaqe envelop for administration of either intravenous noted [IV] Labetalol or Hydrallazine. The mean fall in the MAP in each group was noted. This data was compared by applying SPSS version 13. The study was conducted from November 2012 to April 2013
Results: The mean [+/-SD] age of the labetalol group was 27.46 [+/-5.28] years while that in the hydralazine group was 26.28 [+/-5.17] years. The mean fall in MAP observed in the labetalol group was 29.10 +/- 7.21 mmHg and that in the hydralazine group was 25.05 +/- 10.15 mmHg which was statistically significant with the p value being 0.046
Conclusion: Intra Venous labetalol lowered MAP more than hydralazine, when administered to pregnant females with severe Pregnancy induced hypertension [PIH] and pre eclampsia [PE] in pregnancy
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Objective: To determine the positive predictive value of magnetic resonance spectroscopy in diagnosing malignant thyroid nodules by taking histopathology as a gold standard
Methodology: This descriptive cross-sectional study was undertaken at the department of Radiology, CMH Multan from October 2014 to March 2015. 77 patients with malignant thyroid nodules on ultrasonography between ages 30-70 years, of either gender were included. Patients with previous thyroid surgery, already biopsy proven malignant thyroid nodules and, those having contraindication to magnetic resonance spectroscopy [MRS] were excluded. All the patients then underwent MRS for choline peak and choline /creatine [Cho/Cr] ratio. Findings were correlated with histopathology
Results: Mean age of the patients was 46.53 +/- 9.15 years. Out of these 77 patients, 62 [80.52%] were female and 15 [19.48%] were males with female to male ratio of 4:1. MRS supported the diagnosis of malignant thyroid nodules in 60 patients. Histopathology confirmed malignant thyroid nodules in 49 [true positive] cases where as 11 [False Positive] had no malignant lesion on histopathology. Positive predictive value of magnetic resonance spectroscopy [MRS] in diagnosing malignant thyroid nodules was 81.67%
Conclusion: Magnetic resonance spectroscopy [MRS] is a non-invasive modality of choice with high positive predictive value in diagnosing malignant thyroid nodules. It has not only dramatically improved our ability of diagnosing thyroid lesions pre- operatively but also helps the surgeons for proper decision making
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Introduction: Helmand province, whose capital is Lashkar-Gah, is one of the most volatile provinces affected by the conflict in Afghanistan. Doctors without Borders began to work in Boost Hospital in 2009. Method: Retrospective review of surgical procedures at the Doctors without Borders Operational Center in Brussels, February 11, 2010 to September 30, 2012. Results: 5719 surgeries were performed on 4334 patients. 47% were emergency interventions and 75% were first interventions. 39.7% (n = 1721) of patients were female. In the Gyneco-obstetric (G) area, the average age was 31.3 years. 848 Cesarean operations (76%) were performed and 95% of these were urgent. Of these patients (n = 598) 64% were at ASA II. Spinal anesthesia (SA) was administered in 44.4% (n = 415) of patients, followed by general anesthesia without intubation (GA-) in 39.3% (n = 367). In 16% (n = 151), general anesthesia was administered with endotracheal intubation (GA+). Transoperatory mortality was 0.8% (n=7). Conclusions: The Boost Hospital offers a surgical service of relevance in the south of Afghanistan. This hospital is supported by Doctors without Borders (MSF) and has helped to reduce the maternal mortality in that region through the provision of quality care in obstetric emergencies. By applying health standards, and medical teams and material, MSF has helped the Afghan population, particularly gestating mothers, to improve its health while achieving a transoperatory mortality in Cesareans of <1%.
Introducción: Helmand cuya capital es Lashkar-Gah es una de las provincias más volátiles entre las más afectadas por conflictos en Afganistán. Médicos sin Fronteras empezó a trabajar en el Hospital Boost en 2009. Método: Revisión retrospectiva de procedimientos quirúrgicos en Médicos sin Fronteras-Centro Operacional de Bruselas del 11 de febrero de 2010 al 30 de septiembre de 2012. Resultados: Se realizaron 5719 cirugías a 4334 pacientes, siendo de urgencia un 47% y primera intervención un 75%. 39.7% (n = 1721) de pacientes fueron de género femenino. En relación al área Gineco-obstétrica (G), la edad media fue de 31.3 años. Se realizaron 848 cesáreas (76%) de las cuales el 95% fueron urgentes. De estas pacientes (n = 598) el 64% era ASA II. En cuanto al tipo de anestesia, se administró Anestesia espinal (SA) en un 44.4% (n = 415), seguido de anestesia general sin intubación (GA-) en un 39.3% (n = 367), y en un 16% (n = 151) se administró anestesia general con intubación endotraqueal (GA+); con una mortalidad transoperatoria de 0.8% (n = 7). Conclusiones: El Hospital Boost brinda un servicio quirúrgico de relevancia en el sur de Afganistán. Dicho hospital es apoyado por Médicos sin Fronteras (MSF), lo cual ha ayudado a reducir la mortalidad materna en esa región con la provisión de asistencia de calidad en emergencias obstétricas. Con la aplicación de estándares de salud, equipo, y material médico, MSF ha logrado que la población afgana, y particularmente las gestantes, mejore su salud, logrando una mortalidad transoperatoria de intervenciones por Cesáreas de < 1%.
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HumansABSTRACT
A case series was conducted at our institution on the the use of self-expanding metal stents (SEMS) in the cervical esophagus and their tolerability. Departmental records identified 20 consecutive stents placed in the cervical esophagus of 12 patients at our institution. There were 6 men and 6 women, mean age 67.2 years (range, 47.6-91.6 years). Ten patients had either primary or recurrent malignant disease and two had benign disease; a recalcitrant stricture at the oesophago-gastric anastomosis following oesophagectomy and a tracheo-oesophageal fistula secondary to tracheomalacia. Three patients received multiple stents on separate occasions requiring 2, 3, and 6 stents. Nineteen stents were placed radiologically with fluoroscopic guidance via a per-oral route under conscious sedation, and one was placed under direct endoscopic visualisation. Patients were followed up until death or to date. All stents were successfully deployed across the strictures. There was no foreign body sensation (FBS) reported after 16 of the procedures (80%). One patient reported transient FBS. Three stents were removed without complication because of symptoms; the endoscopically placed stent which was within 5 mm of cricopharyngeus and two which were inadvertently deployed across cricopharyngeus. There were no other significant complications related to the stent or procedure. All patients reported significant improvement in dysphagia with dysphagia scores improving from a mean of 3.1/4 to 0.9/4 (Wilcoxon matched-pairs signed-ranks test, P = 0.0158). One stent migrated in a patient with malignant disease; however, all 6 stents placed across the benign stricture migrated. Hence our case series concludes that SEMS can be safely and effectively deployed in the cervical esophagus.
Subject(s)
Female , Humans , Male , Conscious Sedation , Constriction, Pathologic , Deglutition Disorders , Esophagus , Fistula , Foreign Bodies , Pharyngeal Muscles , Sensation , Stents , TracheomalaciaABSTRACT
Objective: To assess association between menstrual irregularities and socioeconomic status in adolescent girls
Study Design: Cross sectional study
Place and Duration of study: This study was conducted at different schools and colleges of Karachi from December, 20[th] 2010 to 15[th] January 2011
Materials and Methods: The study included 650 girls from schools and colleges of Karachi district representing different socio economic groups. A questionnaire was constructed comprising of biodata, menstrual cycle pattern and details of dysmenorrhea and premenstrual syndrome [PMS]. Girls between 15-19 years were selected randomly from schools and colleges representing low, middle and high income group. They were requested to fill questionnaire. Information thus obtained was analysed on spss version 11
Results: A total of 611 questionnaires were analyzed. 33.2% of adolescent girls belonged to low income group, 30.3% were from middle and 36.5% from high income group. Mean age of girls was 16.7 years. Menstrual cycle pattern was regular in 75.28% girls. No difference was found in cycle pattern between different socioeconomic groups. 83.79% girls complained of dysmenorrhea and 34.76% of them were from low income group, 29.49% from middle and 35.75% from high income group. Treatment of dysmenorrhea was required in 14.56% girls, including 41.57% from low, 24.71% middle and 33.8% from high income group. PMS was noted 71.68% girls. 36.1% girls reporting PMS were from low and 32.2% and 31.7% from middle and high income group respectively
Conclusion: Menstrual cycles are regular in majority of teen age girls. Dysmenorrhea and PMS are prevalent menstrual disorders in young adolescents. Incidence of PMS is significantly higher in low socio-economic group
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Objective: The objective of the study was to evaluate the various cause and clinical presentation in patients having pancytopenia in tertiary care hospital
Study Design: Descriptive / cross-sectional
Place and Duration of Study: This study was conducted in the Medicine Department of LUMHS, Jamshoro from 2013-2015
Materials and Methods: Total 80 cases of pancytopenia were enrolled in the study. Patients were included above age of 15 years from both sexes. Pancytopenia was defined as: WBCs [
Results: Total 80 cases were studied, who represented pancytopenia. Male were in majority 61[76.25%]. Majority of the young cases was found with mean age of 33.23 years. Most common clinical feature was found general weakness in 19[23.75%] patients followed by fever [18.75%], dyspnea 11[13.75%], bone pain 6[7.5%], anemia 6[7.5%] and pain in legs in 4[5%] patients. According to the etiological pattern aplastic anemia and malaria was found most common in 18 [22.5%] and 11 [13.75%] cases respectively
Conclusion: Aplastic anemia and malaria was the commonest factor of pancytopenia in this study mostly in young males. The commonest clinical presentation observed was generalized weakness after that fever and dyspnea
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Objective: To assess the outcome and safety of sacrohysteropexy as uterus conserving surgery for pelvic organ prolapse in young women and to assess patients' satisfaction with the procedure
Methods:This is a case series of patients operated at Sind Government Lyari General Hospital and Civil Hospital Karachi, between January, 2007 to October, 2015. Data of the patients who had sacrohysteropexy were reviewed. Complications during surgery and post-operative period including haemorrhage, visceral injury, paralytic ileus and peritonitis were studied. Success of procedure, need of blood transfusion, hospital stay and condition on discharge and six weeks follow-up were noted. Data were analyzed using SPSS version 16. Mean +/- SD was calculated for numerical, while frequencies were computed for categorical variables
Results:Data of 60 patients were reviewed. Early post-operative success was 100%. Duration of surgery was less than two hours in 57 [95%] patients. Blood loss was negligible in majority of cases. Out of all 60 cases, 52 [86.7%] did not suffer any complication. One patient had ureteric injury, while one patient sustained bowel injury. Two patients had paralytic ileus. Four patients suffered from abdominal wound infection. All patients were managed satisfactorily. Mean duration of stay in hospital was four days. Upon follow up 96.7% patients were satisfied with results of operative procedure. Sixteen [26.7%] patients complained of backache on follow-up visit
Conclusion:This review concludes that sacrohysteropexy was successful in all cases in early post-operative period. It is a safe procedure and should be considered as an option for the treatment of pelvic organ prolapse in young women, in whom uterine conservation is required
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Objective: our hypothesis was that an EEG recording of 20 minutes' duration would yield more information than a 10-minute EEG in capturing epileptiform abnormalities
Methods: the study was conducted in electrophysiology section of neurology department of services hospitals, Lahore during 2012. Total 171 consecutive EEG patients were evaluated
Results: we prospectively studied 171 consecutive EEGs [patients of 16-29 years old] of 20 minutes' duration performed at Services Hospital. Although the majority [89%] of interracial EEG abnormalities can be identified within the first 20 minutes of a routine EEG, extending the time of a routine EEG may increase the yield. The single electrical abnormality was found to appear between 11 to 14 minutes
Conclusion: it should be emphasized that every EEG should be done for at least 20 minutes duration as recommended, especially when the first 10 minutes are normal
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Objective: To determine the diagnostic accuracy of ratio of platelet count to spleen size for prediction of esophageal varices in patients of liver cirrhosis, keeping upper GI endoscopy as gold standard
Materials and Methods: This cross-sectional validation study was carried out in Radiology Department, Combined Military Hospital, Peshawar from February, 2015 to August, 2015.One hundred and fifty patients of either sex, having liver cirrhosis with no episode of gastrointestinal bleeding, scheduled to undergo upper GI endoscopy were selected.Ultrasound abdomen of these patients was carried out and spleen size was determined in millimeters. Platelet count if already not performed was also carried out.Platelet count was divided by the spleen size to obtain the platelet count to spleen size ratio. Close follow up of the patient was done until he/she underwent upper GI endoscopy for diagnosis of esophageal varices. A correlation was performed between the platelet count to spleen size ratio and findings of upper GI endoscopy
Results: Collected data was analyzed through computer software SPSS11.0.The ratio of platelet count to spleen size as a predictor of esophageal varices in patients of liver cirrhosis demonstrated sensitivity of 92.5%, specificity of 87.5%, positive predictive value of 93.3%, negative predictive value of 86.1% and diagnostic accuracy of 90.8%
Conclusion: The ratio of platelet count to spleen size as a predictor of esophageal varices in patients of liver cirrhosis is found to be high