Bacterial infections in paediatric patients with chemotherapy induced neutropenia

To determine the pattern of bacterial infections, isolate and identify the pathogenic bacteria and their sensitivity to different antibiotics during febrile episodes in paediatric patients with chemotherapy induced neutropenia from January to June 2000 at the Paediatric OncologyUunit of Combined Military Hospital, Rawalpindi [CMH RWP]. Patients and The study material comprised of 62 febrile episodes occurring in 50 neutropenic children aged less than 12 years with various malignancies. All the episodes were worked up in detail including history, physical examination and relevant investigations. Total 29 bacteria were cultured in 62 febrile episodes. Fifty five% organisms were isolated from blood and 45% from other sites, 15 [51.7%] were Gram-positive and 14 [48.3%] were Gram-negative. S. aureus was the most frequent Gram positive isolate and E. coli was the most common Gram negative isolate. The standard empiric antibiotic regimens for [combination of amikacin and ceftazidime] showed an overall response rate of 61.3%. The infection related mortality in this series was 22%. Fever is the commonest symptom of infection in neutropenic children with malignancy and demands an urgent empirical antibiotic therapy after the onset of fever. Based on this study we recommend a combination of ceftazidime and amikacin for use as empiric antibiotic therapy in these children

Computer tomography appearance of hydatid disease of the liver

The purpose of the study is to evaluate the use of computed tomography [CT Scan] in the diagnosis of hydatid disease of the liver. The diagnosis was definite in all 25 patients examined. Possible appearance is discussed. The right lobe of the liver was involved in 23 cases [92%]. Unenhanced CT Scan revealed the exact location extension of the cysts and possible intrahepatic complications

Squamous cell carcinoma derived from the wall of emphysematous bullae

We report a case of 56 year old male who presented with infected emphysematous bullae and negative radiological tumour shadow on plain radiography and suspicious on CT Scan proved to be a squamous cell carcinoma. Squamous cell carcinoma has been reported that arise from wall of emphysematous bullae before in the literature

Water lify sign in a liver hydatid cyst

Hydatid disease is a parasitic infestation of man and other vertebrates with the dog tape worm, Echinococcus granulosa. The liver and lungs are the organs most involved and the disease is manifested with single or multiple cyst formation. Should some of the fluid contents of the cyst leak, the cyst may shrink and the folded-up membrane contrast against the surrounding air which has replaced the fluid producing an appearance similar to a water-lily. Though, at the time of diagnosis, nearly 36-40% of hepatic cysts have been ruptured or became infected, this sign has been rarely reported in the liver

Solitary pulmonary hydatid cyst rediologically simulating a giant emphysematous bulla

In this case report we present a case of large solitary hydatid disease of the lung which was discovered incidentally. The lesion was similar to bullous emphysema with its thin wall and absence of calcification. CT scan examination was useful especially the CT attenuation number of its internal structure which was nearly one Hounsfield unit [HU] indicating the serous nature of its content as compared to -100 HU which was characteristic of air in emphesematous bullae

Accessibility of health establishments and their utilization

Adequate information on the availability, accessibility and utilization of health facilities was not available for developing appropriate plans for health sector. This paper outlines the results of a study undertaken to yield some of the requisite information for health planning, Number of health establishments, along with staffing pattern and budget allocations, studied as on 31.12.75 was 4,484. These were primarily owned by Government or supported by semi-government organizations. On an average a health institution, regardless of type, was available for a population of 15,280, and a hospital bed for 1,820 persons. Inter-provincial comparisons, unit cost of treatment, bed occupancy rates and condition of physical plants are given in the report The main finding of the study was that 50% of the population was estimated to be within 2 miles distance of the outlets of the modern health services. Nearly 100% of urban population whereas 32% of rural population was within 2 miles radius of health units, 19.2% of rural population had no access, to any health facility even within 5 miles not even a paramedic. On an average a hospital bed was available for 570 persons in the urban areas and 9,190 persons in the rural areas, but 59-80% of total beds were occupied by persons belonging to rural areas. Health units located in the urban areas were better staffed than units in the rural areas. The largest number of posts lying vacant were those of doctors followed by nurses. Vacancy rate for paramedicals was negligible. 66.6% of vacant posts for doctors are in rural as compared to 21.3% in urban localities