Diagnostic accuracy of ultrasonography in diagnosing maxillary sinusitis

Objective: To determine the diagnostic accuracy of ultrasonography in diagnosing maxillary sinusitis while keeping magnetic resonance imaging as gold standard. Study Design: Cross sectional, validation study. Place and Duration of Study: Radiology Department Combined Military Hospital Rawalpindi, from Mar 2014 to Sep 2014

Material and Methods: Consenting three hundred and ninety-one patients diagnosed clinically as a case of maxillary sinusitis at Combined Military Hospital Rawalpindi during the study period fitting the inclusion criteria were selected. Ultrasonography of maxillary sinuses focusing on mucosal thickening, fluid level and cystr polyp was done for all patients. After ultrasonography all patients underwent MRI at our department to look for mucosal thickening, fluid levels and total opacity appearing hyperintense on T2 weighted sequence. Diagnostic accuracy of ultrasonography was evaluated in the diagnosis of maxillary sinusitis

Results: The sensitivity of Ultrasonography in diagnosis of maxillary sinusitis keeping MRI as Gold Standard was quite low at 40.15%. The ability [specificity] of Ultrasonography in diagnosis of maxillary sinusitis taking MRI as Gold Standard was good i.e. 84.67%. The diagnostic accuracy was encouraging at 55.75%

Conclusion: Ultrasonography had low sensitivity but high specificity in diagnosis of maxillary sinusitis

Effectiveness of steroid therapy in newborns with meconium aspiration syndrome at NICU, Gangaram Hospital, Lahore

Objective: meconium aspiration syndrome [MAS] is one of the serious and life-threatening disorders in newborn infants and is still one of the most challenged neonatal diseases. This study was conducted in order to determine the efficacy of steroids use in the management of this syndrome

Study Design: this was a randomized controlled study

Period and Place of study: six month period in the neonatal unit of the Gangaram hospital, Lahore

Materials and Methods: we included sixty eight [68] babies with MAS which were then distributed randomly into two groups i.e. Group A [n = 34], patients in this group served as controls and Group B [n = 34], patients who were treated with steroids. Injectable decadron was administered at 0.2mg per kg per day in two divided doses [i.e. every 12 hours]. Infants in present trial were evaluated on the basis of duration of stay at hospital, mortality rate and were also assessed for other morbidities and infections

Results: we observed a statistically significant difference in the duration of stay between the two groups. However, the use of steroids was not correlated with mortality rate since it was same in two groups

Conclusion: the conclusion of our study is that steroids revealed shorter duration of stay and less morbidity I newborns with MAS affect the mechanistic way of MAS and thus favorably affect the outcome

Frequency of meningitis in neonatal late onset sepsis in Gangaram Hospital, Lahore

Objective: bacterial sepsis and meningitis are still major causes of morbidity and mortality in newborns all over the world, especially in premature infants. They must be recognized and treated quickly to prevent death or disability

Study Design: this prospective cross-sectional study

Period and Place of study: 6 months period in Pediatrics Department of Sir Gangaram Hospital Lahore

Materials and Methods: a total of 190neonates fulfilling the inclusion criteria [> 7 days with positive septic screen] were included and subjected to detailed history, clinical examination followed by investigations. All babies with positive septic screen underwent lumber puncture [LP] and cerebral spinal fluid [CSF] was sent to laboratory for cytology and biochemistry

Results: mean age of patients was 15.6+/-6 days with a male to female ratio of 1.6:1. Frequency of Meningitis in babies with late-onset sepsis was 39.5% [75 patients out of 190]

Conclusion: meningitis is commonly associated with late onset sepsis hence LP should be done as standard protocol in such neonates and the outcome is directly proportional to the diagnosis at initial presentation

Income status and medical history of older persons in Rawalpindi: anthropology of ageing

The aim of study is to highlight the hidden ageing population and its problems. The specific purpose of the study was to explore the interrelationship of ageing with income as well as the medical history among the older persons of Rawalpindi city. Cross Sectional. This study was commissioned to the research team on behalf of Help Age Pakistan. The data collection was done in various union councils of Rawalpindi city. The study duration was three months of 2013. Structured questionnaire was developed to collect information on Older Persons' health, economic and psychological status. In this regard, an extensive questionnaire was designed and pre-tested vigorously. Number of researchers form PMAS-Arid Agriculture University was engaged to collect data. There is a strong relationship between the income statuses of OPs with their health physical conditions. The lack of permanent source of income leads to the high tendency of contracting various health problems among OPs. Similarly the inactive status of OPs also affects their health wellness which later on leads to create a multiplier effect regarding various health problems like heart problems, hypertensions, diabetes, arthritis, asthma, etc. There is a strong relation of income stability with the various psycho-somatic problems. The sense of being actively involved in familial functions especially economic chores provide a sense of independence and psychological sense of control over life results in better health among OPs

Evaluation of clopidogrel in inhibition of platelet aggregation

Evaluation of in-vivo therapeutic effects of Clopidogrel 75mg [Lowplat] given once daily for seven days to the patients requiring antiplatetet therapy. This is an open label, multicenter study to determine the platelet aggregation inhibition of the study drug in adult subjects suffering from diseases requiring antiplatelet therapy i.e. coronary artery diseases [CAD], peripheral vascular diseases [PVD] and cerebro vascular accident [CVA], presented at different hospitals and clinics in Faisalabad. Mean platelet aggregation inhibited by [LP] was 66% [P <0.001] and standard deviation was +/- 10%, which is statistically significant. This study proves that the Lowplat [LP] is effective in reducing platelet aggregation significantly in Pakistani patients' who require antiplatelet therapy. The cost benefit of locally manufactured drug may be passed on to the patients

seven year study [2000 - 07] of the cleft proportions at the cleft clinic of the children's hospital, Lahore

The study assessed proportions of clefts in patients visiting orthodontic unit of Children's Hospital Lahore from 24-01-2000 to 24-01-2007. This observational descriptive study included 313 subjects comprising 189 males and 124 females with the age range of day one to 13 years. The method used for this study was Kernahan's modified double 'Y' with numeric coding. A total of 30 combinations were used to describe all types of clefts. The data was analyzed using SPSS 12. An increased proportion of the male patients [189] was examined compared to 124 females. The most common finding was complete bilateral cleft affecting 126 cases [40.3%]. The second common type was complete unilateral cleft seen in 95 patients [30.4%]. The clefts involving the left side were more common and were identified in 54 patients [17.3%]. The 3[rd] largest type was cleft involving median soft palate. An unusual finding of this study was complete unilateral and partial clefts of the opposite side found in 21 infants [6.7%]. The most common finding was complete bilateral cleft of the lip and palate. An unusual type of cleft was identified with Kernahan's double 'Y'

Pattern of lipid profile in type-2 diabetes mellitus patients

To know the pattern of lipid profile in obese and non-obese type-2 diabetes mellitus patients as compared to a control group One hundred [50 obese and 50 non-obese] diagnosed patients having diabetes mellitus minimum for the last three years were randomly selected from the outdoor patient department of medicine, Khyber teaching hospital, Peshawar during the year 2002. Obesity was taken as body mass index of more than 25 kg/m[2]. One hundred healthy individuals were selected from among the staff of Khyber medical college, Khyber College of Dentistry, and Khyber Teaching Hospital, Peshawar to constitute the control group. They had no history of any chronic illness. Subjects suffering from cardiovascular diseases, kidney disorder and hepatic disorders were excluded from the study. Fasting serum triglyceride, total cholesterol, HDL-C, LDL-C, and VLDL-C were determined by enzymatic calorimetric method and calculated by using Friedewald [1972] formula. The levels of serum triglycerides [170.15 +/- 10.3 mg/dl vs 159.01 +/- 10.11mg/dl], total cholesterol, [191.61 +/- 18.61 mg/dl vs 182.61 +/- 17.6 mg/dl], LDL-C [113.12 +/- 11.01mg/dl vs 102.69 +/- 11.17 mg/dl] and VLDL-C [34.03 +/- 2.03 mg/dl vs. 31.80 +/- 0.2mg/dl] were higher in diabetic patients as compared to the control group, while HDL-C [43.39 +/- 6.41 mg/dl vs. 57.69 +/- 7.06 mg/dl] was lower as compared to the control group. Dyslipidemia is a significant finding in type-2 diabetes mellitus patients

Management of the cleft deformities at the cleft center of Children's Hospital Lahore during 5 years [2000-2005]

To describe management of cleft children during five year period from 24-1-2000 to 24-1-2005 at Orthodontic department of the Dental section CH and ICH Lahore, a tertiary level hospital. This quasi experimental study was conducted on 128 subjects comprising of 72 males and 56 females. Age of these subjects ranged from one day to thirteen years. These patients were classified with Kernahan's modified double Y system. Thirty six patients out of 54 [42.2% with complete bilateral cleft lip and palate] were treated with custom made orthopedic plate having anteriorly extending acrylic ring. The next common type of cleft seen was complete unilateral cleft lip and palate affecting 27 patients [21%]. An unusual finding was complete unilateral cleft lip and palate and partial opposite side cleft. Treatment given to unilateral cleft was pre-surgical infant orthopedic plate given in 30 patients. Supportive instructions were provided to 21 infants that included 10 neonates with Pierre Robin's sequence. 19 subjects out of the whole sample were given post surgical Obturators for the treatment of residual fistula or cleft following palatal closure. Ten patients were instructed on oral hygiene measures. Four patients were referred for surgical procedures. Three patients in early mixed dentition were provided custom made modified expansion device. One patient in mixed dentition was given Petit headgear after expanding maxilla with splinted hyrax while another one was given holding arch. Three patients, two in mixed dentition and one in permanent dentition were treated with comprehensive fixed mechanics followed by bone graft. In bilateral deformities PSIOP with anterior ring produced significant retraction of pre maxilla which made initial lip repair easy. In unilateral cases PROP served the purpose of obturator and improved the function while MED provided an effective substitute to splinted expanders

Effects of long-term use of tobacco on taste receptors and salivary secretion

Most of the methods of tobacco use are linked to the mouth, where the taste receptors, a primary site for stimulation of salivary secretion, are constantly exposed to tobacco. The main purpose of this study was to observe the effects of long-term use of tobacco on taste receptors and salivary flow rates. Subjects of the study were divided into smokers, pan, [tobacco-betel-lime quid] chewers, niswar [moist oral snuff] dippers and non-tobacco users as controls. Each group was comprised of 20 healthy male adults. 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. The appreciation of taste sensations perceived by each subject of each group was different for nicotine [bitter unpleasant burning sensations] than citric acid [sour burning sensations] but no subjective difference was observed among the corresponding groups. After stimulation with both nicotine and citric acid, all subjects of each group showed a significant rise [p<0.05] in their salivary flow rates but the increase was highly significant [p<0.005] in pan chewers only. We found that the taste receptors response and salivary flow rates of tobacco users were not much different from that of non-tobacco users. Therefore, we conclude that long-term use of tobacco does not adversely affect the taste receptors response and hence salivary secretion