Diagnostic accuracy of platelet count to spleen size for prediction of esophageal varices in patients of liver cirrhosis

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

Congenital hypothyroidism: an underestimated clinical entity

The aim of study was to determine the clinical features of Hypothyroid Children in various age groups residing in Rahim Yar Khan. Prospective, descriptive, study, over a span of one year. This study was conducted in Pediatrics department at Sheikh Zayed Hospital and Medical College Rahim Yar Khan from 1st March 2010 to March 2011. The thirty children of both sexes in age group of 1 day - 12 years presenting with clinical features, suspicion of Hypothyroidism were included in study. Children with subtle as well as full fledged sign and symptoms of hypothyroidism were considered for further evaluation. The clinical history, feeding pattern and clinical examination of these cases were recorded. Their blood was examined for T4, T3 and TSH. The X-rays of chest, X-rays of Skeleton, particularly X-ray wrist and X-ray knee joint were obtained. Serum cholesterol, glucose, electrolytes [Na[+] and K[+] and perchlorate [KC10[4] discharge test were obtained. Thyroid scintigraphy was done for isotope uptake. Ultrasonography for thyroid position, its size and detection of solid and cystic lesions was performed.Cardiac monitoring was gained by E.C.G. The data analysis was done by software SPSS 16. All children with clinical features and investigations in favor of hypothyroidism were kept in four groups according to the age. The sluggish behavior, bradycardia, typical coarse faces and TSH in values above normal range were consistent findings in all thirty [n=30] cases. Congenital Hypothyroidism is usually under diagnosed that leads to mental retardation in a child. Therefore any child having suspicion of hypothyroidism should be evaluated by thyroid functions test [TFT], including new born screening

Secretion of total solids [solutes] in the saliva of long-term tobacco users

It is generally believed that repeated exposure of a receptor to a stimulus results in inactivation [suppression or adaptation] of the receptor .Most of the methods of tobacco use are linked to the oral cavity where the taste receptors, a primary site for stimulation of salivary secretion, are constantly exposed to tobacco for long time. The present study was designed to document changes in salivary concentration of total solids in response to this effect in chronic tobacco users, if any. Subjects of the study were divided into smokers, pan [tobaccobetel- lime quid] chewers, niswar [moist oral snuff] dippers and non tobacco users as controls. The saliva of each subject was collected under resting condition and following application of crude nicotine and citric acid solutions to the tip of his tongue. After stimulation with nicotine all groups showed a decrease in the total solids concentration but the decrease was not significant in any group. After stimulation with citric acid, further decrease was seen in all groups but it was also insignificant statistically. We conclude that the total solids concentration decreases with the increase in salivary flow rates [and vice versa] in long-term tobacco users, salivary reflex is not adversely affected by long-term use of tobacco and this observation is not much different from that in non users

Effect of noise on heart rate

The objective of the study was to observe the effect of short-term noise on heart rate. One Hundred and seventeen [117] medical students were selected as subjects. Subjects having normal resting heart rate and blood pressure were included in the study. Subjects with, hearing defect were excluded from study. Auditory aquity was confirmed by audiometry before the start of experiment for each subject. A noise of a 90 dB intensity and 4000Hz frequency was produced for 10 minutes. Heart rate was recorded before, during and after exposure to noise. Heart rate increased in 104 [88.9%] subjects, with an average rise of 8.938+ 1.037. In 73 subjects [70.19%] it came back to basal level within 02 minutes. Increase in heart rate was observed in more number of males as compared to females; however, the difference was statistically insignificant. Heart rate increases during exposure to noise

Role of sonourethrography in evaluation of anterior urethral stricture and its comparison with retrograde urethrography

The aim of this study was to compare retro grade urethrography [RUG] and sonourethrography [SUG] for assessment of urethral strictures and to evaluate whether RUG underestimates stricture length, as has been reported. Quasiexperimental study. The study was performed in the department of Radiology PNS Shifa Karachi from January 2004 till December 2004. Forty male patients diagnosed with anterior urethral stricture were assessed for presence of strictures and their length by conventional contrast urethrography and sonourethrography. Contrast urethrography was carried out by retrograde injection of Urograffin 76% under fluoroscopic guidance. Sonourethrography was done with a 7.5 MHz small parts transducer. Stricture lengths were recorded and compared. Analysis of the results showed that the estimation of stricture length measured by contrast urethrography was under-estimated as compared to sonourethrography. The difference between the two tests was significant [P < 0.001] and the correlation coefficient was poor [r = 0.493]. When the strictures were grouped into penile and bulbar anatomical locations the results remained highly significant in the bulbar region [P = 0.0001] however no significant difference was found in the estimated length for penile strictures [P = 0.25]. Sonourethrography is a good adjunct investigation before definitive surgical therapy particularly in the bulbar region where conventional contrast urethrography was shown to underestimate stricture length significantly

Association of serum uric acid with type II diabetes mellitus

Objective: to find out the association of serum uric acid with type- II diabetes mellitus and to compare the level of serum uric acid between obese and non-obese type-I1 diabetics

Material and Methods: fifty obese and fifty non-obese diabetic patients were included in the study one hundred non-diabetic subjects were selected as control group. The results were analyzed by t-test for serum uric acid, glucose and lipid profile

Results: the mean level of serum uric acid in obese type-II diabetic patients was 6.07 mg/dl as compared to 5.01 mg/dl in the control group. The difference was significant statistically

Conclusion: hyperuricemia is significantly associated with type-II diabetes mellitus and can increase the morbidity and mortality from diabetes if not managed in time

Effect of 90 decibel noise of 4000 hertz on blood pressure in young adults

Almost every individual dislikes excessive and unnecessary noise. Noise exerts various adverse psychological and physiological effects, on human body including a rise in blood pressure. 117 volunteer medical students, aged 18-23 years were exposed to 90 decibel noise of 4000 hertz for 10 minutes, produced by audiometer in a sound-proof room. Blood pressure was recorded every three minutes. Blood pressure increased during exposure to noise. Average rise in systolic blood pressure was 2.462 +/- 0.532 mm Hg and average rise in diastolic blood pressure was 3.064 +/- 1.047mm Hg. Blood pressure came to resting value within two minutes after stopping exposure to noise in more than 50% of the subjects. Systolic and diastolic blood pressure increases due to noise exposure