Epidemiology of amputation; low resource community: Sindh province, Pakistan [October 2007- june2012]

Amputation is stated to be a foremost but preventable community health problem causing intense financial, social and emotional effects on the patient and family particularly in developing countries where the prosthetic services are limited. The purpose of this study was to identify the causes and levels of amputation in low resource community, Sindh Pakistan. This was a retrospective chart review study that was carried out at first civilian Institute of physical medicine and rehabilitation-Dow University of health sciences from October 2007 to June 2012. After verbal informed consent all patients, who underwent major or minor amputation were enrolled for the study. Data was collected using a pre-tested, coded questionnaire and analysed using SPSS version 16. A total of 1115 patients were enrolled into the study. Their ages were ranged between 2-95 years [mean 38.40 +/- 17.38]. Among total population of amputees 83.58% were males. The most common cause for major limb amputation was road Traffic accident 38.38%, followed by Diabetes 15.42%, infection 14.26% and trauma 12.37%. Lower limbs [trans-tibial] amputations were in 47.35% of cases and transfemoral in 27.98% of cases. While for the upper limb trans-radial amputation [7.4%] were found to be more common than trans-humeral [5.56%]. Other amputations were for shoulder, hip and knee disarticulations. Road traffic accidents, complications of diabetic foot ulcers, infections and trauma were the most common causes for major limb amputations found in low resource community, Sindh Pakistan. The majority of these amputations are preventable by endowment of traffic rules, health education, early preventions and appropriate management of the common infections

Recognizing the sensory abilities in cerebral palsy children

To evaluate the sensory abilities in different type of cerebral palsy [CP]children. Retrospective, chart review This study was conducted at the Institute of Physical Medicine and Rehabilitation, Dow University of Health sciences from January 22, 2011 to March 23, 2011 in a period of 2 month. 60 CP children already diagnosed with required categories [hemiplegia, diplegia and quadriplegia] without mental retardation between the ages from 4-8 years were included in this study after seeking consent from their parents, while CP children [Athetoid, ataxic, dystonic] below 4 years and above 8 years of age and other developmental disorders were excluded. Convenient sampling was used. A standardized questionnaire was developed to assess parent's perception of their children's sensory profile. It was a self-reporting questionnaire with five point scoring system. Trained Occupational Therapist assisted parents in filling out the form for the collection of data. Data was analyzed by analysis of variance [ANOVA]. The mean age was 5.47Results show that8 out of 38 items have significant value [p 0.05] on Item analysis. Mean value was calculated for each subtypes of CP, therefore classified them according to Dunn criterion on components of short sensory profile. On gender difference significant difference was found on tactile sensitivity, taste/smell sensitivity, under responsive/seek sensation and visual/auditory sensitivity. The differences of classification in each subtypes on seven components along with significant differences on 8 items on short sensory profile indicates that CP children suffer from sensory processing disorder that interferes with their performance. Thus it draws an attention towards a neglected side of palsy so that more accurate assessment and intervention planning could be implemented for effective rehabilitation program of cerebral palsy children