Seroprevalence of hepatitis B Virus [Hbs] In Southern Punjab

To find out the seroprevalence of Hepatitis B Virus Antigen [HBs Ag] detected during blood screening in the candidates of recruitment in Armed forces of Pakistan from Southern Punjab. Observational study. This study was carried out at the Department of Pathology, Combined Military Hospital [CMH], Multan from January to December 2013. Serological blood screening of blood donors and candidates coming for recruitment in armed forces of Pakistan at CMH Multan was performed. Test was performed with rapid screening kit initially and suspected cases were confirmed with third generation ELISA technique. Bio-data of Hepatitis B virus Antigen [HBs Ag] positive cases was collected, analyzed and compared with national and international literature. A total of 10666 persons were screened out, 388 [3.63%] were HBs Ag positive. Seroprevalence of HBs Ag in this region is also high like rest of the world. Public awareness about the disease, prophylactic vaccination against hepatitis B, blood screening before transfusion, use of disposable syringe, proper disposal of contaminated material and prevention from sexual transmission are required to decrease the incidence and its spread

Seroprevalence of hepatitis C virus [HCV] in southern Punjab

To find out the seroprevalence of Hepatitis C Virus [HCV] detected on blood screening in blood donors and candidates for recruitment in Armed forces of Pakistan from Southern Punjab. Observational study. This study was carried out in the Department of Pathology, Combined Military Hospital [CMH], Multan from January to December 2013. Serological blood screening of blood donors and candidates coming for recruitment in armed forces of Pakistan at CMH Multan was performed. Test was performed with rapid screening kit initially and suspected cases were confirmed with third generation ELISA technique. Bio-data of Hepatitis C virus [HCV] positive cases was collected, analyzed and compared with national and international literature. A total of 10666 persons were screened out, 311 [2.91%] were HCV positive. Seroprevalence of HCV in this region is also high like rest of the world. Public awareness about the disease, blood screening before transfusion, use of disposable syringe, proper disposal of contaminated material and prevention from sexual transmission are required to decrease the incidence and its spread

Seroprevalence of human immunodeficiency virus [HIV] in Southern Punjab

To find out the seroprevalence of HIV detected on blood screening in population of Southern Punjab. Observational Study. This study was carried out at the Department of Pathology, Combined Military Hospital [CMH], Multan from January to December 2013. Serological blood screening of blood donors and candidates coming for recruitment in armed forces of Pakistan at CMH Multan Center was performed. Suspected cases confirmed with third generation ELISA technique. Bio-data of HIV positive cases was collected, analyzed and compared with national and international literature. A total of 10666 persons were screened out. Only two [0.018%] was HIV positive. Seroprevalence of HIV/ AIDS is less common in our country as compared to rest of the world especially than that of neighbor countries. Awareness of the disease along with prophylactic and preventive measures are necessary to decrease the prevalence and spread of this disease

Head injury in paediatric population

To study the presentation and outcome of head injury in paediatric patients managed in Children Hospital and The institute of Child Health, Multan. Retrospective Descriptive Study. This study was conducted in the Deptt. of Paed. Surgery, CHandICH, Multan, during a period of five years from Jan 2006 to Dec 2010. A total of 1150 paediatric patients with head injury were managed in this unit. Data was collected on the basis of history, clinical examination, base line investigations, radiological findings including CT scan, diagnosis and management. Patients were divided into three groups according to the severity of injury based upon Glasgow Coma Scale [GCS]. Final analysis and comparison with literature was done. Seventy percent patients were male and 30% female. The age ranged from 1 week to 12 years. Commonest cause was history of fall from height found in 68% cases, followed by road traffic accident 25% and other causes 7%. 70 patients had associated injuries, 5 patients were already mentally handicapped. In 75% cases mild head injury with GCS 14 -15 was present. 35 patients required neurosurgical intervention. 15 patients required treatment for post traumatic seizures. 3 developed brain abscess. 15 patients died in the emergency ward without any surgical intervention within 2 days of admission and 2 died post operatively. Head injury remained a serious problem in paediatric age group with significant morbidity and mortality. Recognizing the pattern of head trauma in children help us to identify high risk groups and environment, which will then help us to design appropriate preventive measures

Congenital diaphragmatic hernia in children

To study the presentation, results and complications of management of congenital diaphragmatic hernia in children at our setup. Retrospective Descriptive Study. This study was conducted in the department of Paediatric Surgery, Children Hospital and The Institute of Child Health, Multan during a period of three years from January 2008 to December 2010. A total of 25 patients with congenital diaphragmatic hernia were managed. Data was collected on the basis of history, clinical examination, relevant investigations, operative results and complications. Final analysis was made at the completion of study. Study included 25 consecutive cases with ages ranging from 12 hours to 7 months. 19 [76%] were male and 6 [24%] female. 20 [80%] were neonates with predominant symptoms of respiratory distress since birth along with cyanosis and apnoeic spells. Five [20%] patients were beyond the age of one month with predominant symptoms of recurrent respiratory tract infection, vomiting and failure to thrive. Clinical signs included absence of breath sounds, presence of bowel sounds and impaired resonance on affected side of chest in all 25 [100%] patients. Flat abdomen in 18 [72%] and cachexia in 2[8%]. Left side involvement was in 22 [88%] and right side in 3 [12%]. All the patients were operated upon. Conventional mechanical ventilation [CMV] was given to 16[64%]. One [4%] patient died and rest of the 24[96%] survived. Best possible operative results can be obtained with the help of limited facilities present in our setup

Prevalence of hepatitis C virus in blood donors

To determine the prevalence of hepatitis C virus in healthy blood donors. A prospective descriptive study. This study was conducted in the Pathology Department Combined Military Hospital, Multan within 3 years from 01-07-2007 to 30-06-2010, A total of 18042 blood donors ranging from 18-55 years of age were screened for hepatitis C virus antibodies by ELISA method. Hepatitis C virus antibodies were positive in 602 [3.3%] Seroprevalence of hepatitis C is high even in healthy young blood donors

Prevalence of hepatitis B virus in blood donors

There is no treatment available once get infected with hepatitis B virus. Transfusion of blood contaminated with HBV is one of the major risk factors for increasing its Seroprevalence. To determine the prevalence of Hepatitis B virus in healthy blood donors. A prospective descriptive study. This study was conducted in department of pathology Combined Military Hospital Multan during a period of three years from 01.07.2007 to 30.06.2010. A total number of 18042 blood donors in between 18-55 years of age were screened for transfusion related carriers of infectious diseases including hepatitis B virus by ELIZA technique. Hepatitis B virus suface antigen was detected in 561 [3.1%] Seroprevalence of hepatitis B is high even in healthy and young blood donors. Therefore every donor should be screened for it

Quantitation of proteinuria by morning spot urine sampling

The study was conducted to determine whether a spot morning urinary protein/cretinine ratio provides accurate quantitation of 24 hours urinary protein excretion in non-diabetic outpatient population. Patients were classified into 5 categories on the basis of urinary protein/cretinine ratio and 24 hours urinary protein excretion was measured in each category and their correlation was studied. Results showed highly reliable correlation between the two and it could be exploited in clinical setting by choosing morning spot urinary protein/cretinine ratio instead of timed urinary protein excretion to quantitate the proteinuria

Hospital acquired acute renal failure: a local perspective

Acute renal failure in hospitalized patient is fearful condition with its attendant high mortality and morbidity. This study looks into the dynamics of hospital acquired renal failure. Compare the overcome in patient with hospital acquired acute renal failure with that of community acquired acute renal failure. To look into clinical profile etiology and outcome of patient who develop hospital acquired acute renal failure. All patients admitted in hospital with normal serum creatinine <1.5 mg/dl who developed >1.5mg/dl after 24 hour of admission were included in the study termed as Hospital Acquired Acute Renal Failure [HAARF]. Patient who had ARF on admission were termed as community acquired acute renal failure [CAARF]. 310 consecutive patients with CAARF. 109 consecutive mortality and morbidity. Drugs [38%] and sepsis [35%] were the commonest reason of HAARF. Patients of HAARF were sicker needed more ICU care/ ventilation and prolonged hospital stay than CAARF. Mortality rate of HAARF was 51% compared to CAARF. HAARF a serious condition mostly results from sepsis nephrotoxic drugs and sensible use of drugs/prevention infection could decrease the incidence of HAARF

Significance of thyroid function tests in growth retarded children

Growth retardation with or without mental retardation is a common problem in children. If remain untreated, patient may suffer permanent physical and mental disability. Aims and objectives of current study were to see the incidence of hypothyroidism in growth retarded children. Sixty nine children presenting with growth retardation were randomly selected, having advised thyroid function tests to investigate the cause of growth retardation. Their detailed history and clinical examination was done. Blood samples were drawn in plain containers, sera were separated and frozen. Batch analysis was done on BYK-Sangtec LIA-mat hormone analyzer. LIA-mat T3, fT4 and TSH kits were used based on the principle of luminescence immunoassay. Commercial LIA-mat controls were run with each batch. Clinical correlation of the results was done. Results revealed primary hypothyroidism in 4 cases and subclinical hypothyroidism in 4 cases. They were given thyroxine replacement therapy resulting in significant clinical improvement. Iodine deficiency may be a contributory factor. It was concluded that early detection of hypothyroidism and its prompt replacement car. prevent life threatening complications. Neonatal screening is recommended, as it is a routine in developed countries

Blood component therapy. A retrospective study at combined military hospital Multan

Whole blood transfusion is mostly practiced in our country whereas blood component therapy is the order of modern medical practice. The aim of the present study was to evaluate the use of blood, its components and the different clinical conditions in which these were used at CMH Multan from June 2001 to November 2001. One thousand and fifteen blood donations were done at the blood bank of CMH Multan. Heraus refrigerated centrifuge was used to prepare blood components. Red cell concentrates, platelet concentrates, leucocytes depleted blood and fresh frozen plasma were prepared. A total of 1310 blood and its component transfusion were studied. Of the 1310 cases 29.38% were males, 38.77% females, 31.8% belonged to pediatric age group. There was significant difference of age distribution among male and female patients. Pregnancy, its complications and caesarian section were the most common indications for blood transfusion. Whole blood was given to 898 cases [68.6%]. Red cell concentrates were given to 241 cases [18.4%]. Fresh frozen plasma/single donor plasma was given to 141 cases [10.7%]. Platelets were given to 30 cases [2.3%]. Leucocyte depleted blood was given to 4 cases [0.3%]. Only 3 non-hemolytic febrile transfusion reactions were noted in patients who were given whole blood. With modern facilities blood components can easily be prepared and their appropriate use can increase the number of patients who can achieve therapeutic benefits. The components should be transfused rather than transfusion of whole blood

Role of arterial blood gas analysis in ventilator setting

Arterial blood gas analysis is a very important life saving investigation. It is required in patients on ventilators. It includes pH, pC02 and pO2 as measured value, and bicarbonate as a calculated value. A study was carried out in CMH Multan to assess the role of arterial blood gas analysis [ABG'S] in monitoring the treatment of patients on ventilator. One hundred patients who were put on mechanical ventilation through ventilators in intensive care units were included in the study. Arterial blood was drawn in heparinized syringe, needle was twisted and capped. Lab was informed about gas analyzer calibration and sample was sent for analysis. Two point calibration of blood gas analyzer was done with pH 6.8 and 7.3 calibrators, slope and cal gas calibrators. Quality controls were run before running the test sample. After discarding a few drops of blood test sample was introduced and print outs of the results were obtained. Results were conveyed immediately to treating physician and anaesthetist for ventilator setting and necessary adjustments were made accordingly. Patients suffering from left ventricular failure were 13, bronchial asthma 4, Guillian Barrie syndrome 8, Cerebrovascular accidents 6, Hemiplegia / coma 8, chronic renal failure 5, head/multiple injury 12, pneumonia 7, COPD 8, Septicaemia 4, electric shock 3, diabetes 13, IHD 8 and tetanus 1. Results revealed metabolic acidosis in 13, respiratory acidosis in 11, mixed metabolic and respiratory acidosis in 5, metabolic acidosis and resp. alkalosis in 3, compensated respiratory acidosis in 11, slightly low P02 in 7, metabolic alkalosis in 4, normal ABG's in 19 and misc results in 22 patients. Patients on ventilator were put on muscle relaxant and his respiratory rate, tidal volume, and oxygen concentration were set on ventilator. It was concluded that as the patient on ventilator is not under control of respiratory centre, ventilator acts as artificial respiratory centre and it needs constant adjustment of parameters like tidal volume, oxygen percentage and peak flow rate according to patients ABG's status