Alternative treatment in Hepatitis B by using polyherbal formulation

The hepatitis B is most prevalent diseases [along with morbidities] in Asian countries. This research study has been conducted to provide an alternative treatment which is safe, effective and cost-effective to comprehend relations of disease, symptoms, patients response and the clinical response via better management of hepatitis B. The goal of this research is to evaluate efficacy and safety of herbal medicine as compared to allopathic medicine in patients suffering from hepatitis B. This was a single blind, randomized controlled clinical trial conducted at Shifa-ul-Mulk Memorial Hospital Hamdard University, Karachi and Dar ul Shifa Unani Dawakhana Karachi, Pakistan. The patients of both genders ranging from 25 to 50 years with symptoms and diagnosed for hepatitis B that fulfilled the criteria for membership, and consented for participation were registered. Ethical committee clearance and permission was obtained from the concerned committee at Faculty of Eastern Medicine, Hamdard University, Karachi, Pakistan. No significant difference was identified after treatment and it was found that the efficacy of Alpha [Control drug] is same as Safoof akseer e jigar [Test drug]. The data offered support to the null hypothesis and therefore research hypothesis was rejected. According to the statistical analysis by chi square, hepatitis B was recorded as negative in 26 patients [57.77%] out of 45 patients by the use of Interferon Alpha [control therapy] and in 27 patients [64.28%] out of 42 patients by the use of Safoof akseer e jigar [test drug]. Comparison of the data recorded of the patients was determined as both drugs showed significant improvement and p value>0.05. The efficacy response is equal in both drugs while test drug showed more safety response. It is concluded that Safoof akseer e jigar possesses as effective a therapeutic value in treating hepatitis B as allopathic medicine

Comparison of ultrasonography with computed tomography findings in evaluation of abdominal aortic aneurysm

Objective: To compare ultrasonography [US] and computed tomography [CT] data for evaluation of abdominal aortic aneurysm. Study Design: Validation study. Place and Duration of Study: Radiology Department Combined Military Hospital Rawalpindi, from Apr 2006 to Jan 2008

Material and Methods: This study involved 67 patients. Both ultrasonography and computed tomography were performed on each patient for evaluation of different variables of abdominal aortic aneurysm. Sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV], accuracy and p-values were calculated for all qualitative variables separately. Mean and standard deviation [SD] were calculated for the quantitative variables

Results: Ultrasound measurements of abdominal aortic aneurysm were both accurate and reproducible. The sensitivity and specificity of ultrasonography for abdominal aortic aneurysm were >90% for all attributes, with minor differences usually resulting from measurement variation rather than failure to distinguish between large aneurysms and normal aortas

Conclusion: Ultrasound was equally effective in comparison with computed tomography not only in diagnosing abdominal aortic aneurysm but also in assessing its different attributes

Role of computed tomography in assessment of blunt trauma abdomen

The objective of the study was to evaluate the usefulness of computed tomography [CT] in assessment of blunt trauma abdomen by correlating their findings with operative findings. Validation study. Radiology Department Combined Military Hospital Rawalpindi from Aug 2005 to Aug 2006. This study involved 30 operatively managed patients. CT was carried out in all 30 patients. Sensitivity, specificity, positive predictive, negative predictive value and accuracy of CT for detection of blunt trauma abdomen were carried out by keeping operation findings as gold standard. CT had shown high sensitivity [88%] in defining solid visceral injuries. Bone injuries of the pelvis identified accurately on sections reviewed with bone window settings and also the sensitivity of CT was reasonably high for bowel and mesenteric injuries [75%]. We concluded that CT had a high sensitivity in detection of blunt trauma abdominal injuries

Diagnostic yield of image guided core biopsy and fine needle aspiration cytology in the evaluation of various masses

The purpose of this study is to evaluate diagnostic yield of ultrasound/ computer tomography [CT] - guided core biopsies and fine needle aspiration cytology [FNAC] of various masses. An observational study. This study was carried out in radiology department of Combined Military Hospital Rawalpindi from Aug 2006 to May 2007. A total of 91 patients with wide range of masses involving different organs of body underwent image guided core biopsies and FNAC. Sixty seven patients were males and 24 were females. Age of patient ranged from were performed under ultrasound guidance. Out of the 91 cases, 48 were core biopsies and 43 FNAC. Biopsies were performed with 18G Monopty gun and FNAC were done with 20-22G lumbar puncture [LP] needle in all cases except FNAC of thyroid gland, cervical lymph nodes and calf muscle [in which FNAC was done with 5cc disposable syringe]. Out of 48 core biopsies, 40 [83.3%] had adequate diagnostic yield and histopathologist was able to give a definite diagnosis. However in 8 [16.7%] biopsies, diagnostic yield was inadequate and it was labeled non-diagnostic by histopathologist. Similarly out of 43 FNAC, 33 [76.7%] had adequate diagnostic yield and 10 FNAC [23.3%] were declared non-diagnostic. Over all success rate was found to be 80.22%. Image guided core biopsies and FNAC, both are very helpful in histophatological diagnosis of various masses and success rate is quite high when appropriate technique is employed

Pattern of gallbladder diseases in Pakistan: an audit of 163 consecutive patients operated at a teaching hospital

To find out the presentation and histological diagnosis of patients with gallstones. A retrospective review of 163 consecutive patients who underwent cholecystectomy in a teaching hospital between 01-01-93 to 31-12-96. Baqai University Hospital, Nazimabad, Karachi. One hundred sixty three patients who underwent cholecystectomy. Histopathological reports of gallbladder. One hundred sixty three patients were operated between 1993 to 1996 at a teaching hospital of Karachi. 96 patients were started as laparoscopic cholecystectomy. Of these, 12 were converted to open procedure. Rest were planned and done as open cholecystectomy. 11 patients had exploration of common bile ducts. The histological reports of all these patients were assessed. The commonest finding was chronic cholecystitis. We however, found that 9 female and 1 male patients had carcinoma of gallbladder. Our management of gallstone disease stems from conclusions based on figures from the West. This study shows that the risk of gallbladder carcinoma may be higher in this part of the world. We have seen that out of 163.patients, 10 patients had carcinoma of gallbladder [over 6%]. This is in sharp contrast to the West where the rate of incidental carcinoma is only 1-2% of routine cholecystectomy. It is about time that a large, multicentral, prospective study is designed in line of that done by Ranshoff et al. to find if the natural history of gallstones is any different in our country

Changes in pattern of bacteraemia at shaikh zayed medical complex Lahore

A retrospective study was conducted on 4101 blood cultures obtained from indoor patients from January 1996 to November 1996 at Shaikh Zayed Medical Complex, Lahore to compare the incidence of bacteraemia and report change in sensitivity pattern of micro-organisms to different antibiotics to that of a study conducted here earlier in 1993-1994. 637 samples were found to be positive and an overall incidence of 26.65 per 1000 admissions were obtained to that of 24.6 per 1000 reported earlier. Surgery department reported the highest percentage of positive cases, 48.82% of the total. The month of July and associated summer months showed a high percentage of positive sample. Staphylococcus species reported highest incidence while Pseudomonas species was close behind [26 and 24% of the total respectively]. Cefotaxime was 72% sensitive and Ceftriaxone was 61% sensitive overall while 97% sensitive for Salmonella species. Chlorampenicol showed resistance to about half the organisms exposed to while Ciprofloxacin was 93.55% sensitive. Ceftazidime was 77.78% sensitive