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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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@#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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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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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.
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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
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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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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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
Objective: To determine frequency of Low Birth Weight [LBW] at term and to determine frequency of various associated risk factors
Methods: This cross-sectional study was conducted in Department of Obstetrics and Gynaecology Layari General Hospital and Dow University of Health Sciences Karachi between January 2007 to July 2008. Women with singleton pregnancy of 37 and above completed weeks were identified. Those women who gave birth to babies with less than 2500gm were recruited in the study. In all those patients who gave birth to LBW babies risk factors were assessed. The variables including age, parity, booking status, maternal weight and height, socioeconomic condition, smoking, fetal gender and birth weight were noted on a questionare. The data was analyzed on SPSS Version 15. Frequency of LBW and its associated risk factors were determined
Results: During study period 10.6% patients delivered LBW babies. Antenatal care was not received in 67% patients. Parity was less than three in 87%. In 26% of patients maternal weight was less than 50 kg and in 37% patients with LBW, maternal height was less than five feet. Majority of patients were anaemic [72%] including 20% with haemoglobin< 7 grams
Conclusion: LBW is associated with a group of factors which may be regarded as high risk factors. These include low socio economic status, anaemia, primiparity, short maternal height and less than average weight
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Objective: to determine the in vitro disk diffusion and MIC patterns of the therapeutic alternatives for Salmonella Typhi
Study Design: a cross-sectional study
Place and Duration of Study: armed Forces Institute of Pathology, Rawalpindi, from June 2011 to May 2013
Methodology: clinical samples were collected from suspected cases of Salmonella infections. Culture was obtained on standard media. Suspected Salmonella colonies were tested by API 20E and confirmed by serology. The isolates were tested for resistance to various antibiotics by Kirby-Bauer disc diffusion method. MIC was done on MDR and ciprofloxacin intermediate or resistant cases by E-strips for selected antibiotics
Results: one hundred and twenty-eight isolates of Salmonella Typhi were recovered from 2230 specimens. Resistance by disk diffusion technique was 72% for ampicillin, 41.2% for cotrimoxazole, 38% for chloramphenicol, 8% for ciprofloxacin, 4.7% for cefpodoxime, 3.5% each for ertapenem aztreonam and moxifloxacin 2.4% for ceftriaxone and 2.3% for doripenem. No resistance was noted for imipenem, cefepime and gatifloxacin. Imipenem MIC[90] was 0.38 and MIC[50] was 0.25. For cefpirome, MIC[90] was 0.64 and MIC[50] was 0.09. For aztreonam, MIC[90] was 0.12 and MIC[50] was 0.09. For cefpodoxime MIC[90] was 0.75 and MIC[50] was 0.38. For azithromycin, these values were 16.0 and 7.0; and for tigecycline they were 0.25 and 0.09
Conclusion: imipenem, azithromycin, tigecycline, aztreonam, cefpodoxime and cefpirome are potential therapeutic agents for resistant Salmonella Typhi infection
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Objective: To evaluate the effectiveness of rectal non-steroidal anti-inflammatory drugs [NSAIDs] using diclofenac in preventing pancreatitis following ERCP
Methodology: It was a randomized, double blinded, placebo controlled study carried out at Surgical Unit-l, Holy Family Hospital, Rawalpindi from May 2013 to April 2014. A total of 108 patients were included and randomly assigned in each of study and placebo groups. Group I patients received 100 mg of diclofenac per rectally while group II patients received a glycerine suppository per rectally [placebo] before the start of ERCP. Post ERCP pancreatitis [PEP] was diagnosed by clinical evaluation and raised serum amylase levels after four hours of the procedure in both groups [study vs control]
Results: Out of 108 patients 32 were males and 76 were females. Mean age was 46.09 +/- 12.31 in group I, while it was 42.93 +/- 14.69 in Group II. Mean serum amylase level, 4 hours after ERCP, was 184.70 +/- 36.34 in the diclofenac group, while it was 388.20 +/- 57.27 IU/L in the control group. Thirty one patients were diagnosed with Post ERCP pancreatitis, out of which nine patients belonged to the study group and twenty two were of the control group [P = 0.000]
Conclusion: Per-rectal administration of diclofenac suppository prior to ERCP results in significant reduction in the frequency of ERCP induced pancreatitis
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Hepatitis B virus is causing serious health concerns in countries like Pakistan. In Khyber Pakhtunkhwa province, 0.6 milion people were estimated to be infected with this virus in 2008. The authors aimed to assess knowledge regarding vaccination, testing and routes of transmission of hepatitis B virus among people of Khyber Pakhtunkhwa, as such knowledge among masses will help limit the infection. People belonging to 12 different districts of Khyber Pakhtunkhwa province were interviewed over a period of 5 months from October 2013 to February 2014. A pre-tested questionnaire was used and in-person survey of randomly selected 1,938 people was carried out throughout the province. Ninety-nine percent people said they knew about hepatitis B virus and 42% said they had got tested for it too. Out of them, 63.2% knew that a vaccine is available for hepatitis B virus. The proportion of respondents, who said hepatitis B virus can spread by sharing razors, toothbrush, syringes or sexual contact, was 97.94%, 95%, 99.3% and 77%, respectively. Only 28.7% knew, it can also spread vertically from mother to child during childbirth. People were quite aware of the routes of transmission of this disease, but they lacked knowledge regarding vaccination and prevention of this menace. Settings should be set up where routine preventive care and immunization services are provided
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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