ABSTRACT
Objective: To determine the frequency of different clinical presentations of cutaneous tuberculosis in a tertiary care hospital
Methods: This cross-sectional study was carried out in the Department of Dermatology, Civil Hospital, Karachi and Department of Dermatology, Ziauddin University, Karachi, over three years from 5[th] March 2007 to 4[th] March 2010. Patients of both sexes and all age groups suffering from histologically-confirmed cutaneous tuberculosis for last 1 month to 10 years were enrolled. A detailed history and examination were recorded on a predesigned proforma. The collected data were computed and analyzed
Results: 57 diagnosed [biopsy proven] cases of cutaneous tuberculosis comprising 35 females [61.4%] and 22 males [38.6%] were enrolled. The age range was 1 up to 80 years. Among these subjects, half the patients were aged between 11-30 years. 17 patients [29.8%] had the disease for 1-2 years constituting the highest frequency for the duration of illness. Most of the patients i.e. 33 [57.5%] had more than one lesion. The lesions were most commonly seen on limbs in 25 [43.4%] patients, followed by face and neck, trunk and genitalia. Chronic discharging sinuses and plaques were the most common presentations. Scrofuloderma was the most common tuberculosis cutis seen in 35 [62%] patients followed by lupus vulgaris, warty tuberculosis and tuberculids. Overall frequency was higher in females. However, some of the types were more frequent in females while others in males. Mean age of presentation for scrofuloderma was 25.7+/-16.9 years, warty tuberculosis 25.7+/-15.9 years, lupus vulgaris 29.4+/-16.5 years and tuberculids 30+/-11.9 years [p=0.197]
Conclusion: Scrofuloderma is the most common clinical presentation of tuberculosis cutis seen in our setting followed by lupus vulgaris, tuberculosis verrucosa cutis and tuberculids
ABSTRACT
Background: Erythropoietin [Epo] and iron therapy plays a major role in the management of renal anaemia. Iron sucrose [IS] has been used to treat iron deficiency anaemia [IDA] and to maintain adequate iron store in chronic kidney disease [CKD]. The objective of the study was to determine the response and safety of IS in the treatment of IDA. Methods: This retrospective study was carried out in the Department of Nephrology, National Institute of Child Health, Karachi from Dec 2008 to Dec 2010. Children aged 6 months to 14 years, CKD-stage 25, and IDA were included. Pertinent data including age, gender, serum creatinine [SCr], CKD-stage, aetiology, treatment mode, IS dose, pre- and posttreatment parameters and side effects were collected and analysed. Results: Among 35, majority [66%] were boys. Mean age was 6.97 +/- 4.13 years and mean SCr was 3.78 +/- 3.1 mg/dl. Majority were in CKDstage 45 and treated conservatively. Major aetiologies were hypoplasia-dysplasia [40%], juvenile nephronophthiasis [17.14%], posterior urethral valves, and stones. Baseline mean Hb and Transferrin Saturation [TS] was 7.38 +/- 1.38 g/dl and 11.19 +/- 5.28% respectively. Mean Hb increased to 9.22 +/- 16.32 g/dl with correction of iron deficit [p<0.001] and a sustained rise in Hb was observed after Epo and maintenance iron sucrose. Mean TS% increased to 49.13 +/- 18% [p<0.001]. No major side effects were observed except iron overload. Conclusion: Iron sucrose was effective in improving IDA in CKD without significant side effects. Iron sucrose may be used to treat IDA with monitoring for iron overload. Keywords: Iron deficiency, anaemia, iron sucrose, chronic kidney disease
ABSTRACT
To determine the outcome of percutaneous renal biopsy [PRB] using Monopty-gun technique [MGT] and to compare the results of sedation with general anesthesia [GA] used for the procedure. Descriptive Study. Department of Pediatrics at National Institute of Child Health [NICH] and the Kidney Center Postgraduate Training Institute [KPTI], Karachi from June 2005 to February 2010. Renal biopsies were performed either under sedation /GA at NICH and KPTI respectively using MGT under ultrasound guidance [USG] after routine tests. A resident/ nurse monitored the procedure. Data including age, sex, indication, vitals monitored, number of attempts per patient, glomeruli per biopsy and complications were recorded. Using statistical-Package-Scientific-Software [SPSS] version- 15, descriptive statistics were applied. Paired test was used to compare pre-and- post procedure vitals. P<0.0 was considered significant. A total of 147 biopsies in 145 children were performed. Boys were 79 [54.58%] and girls 66 [45.51%]. Mean age was 7.31 +/- 4.23 years. Most of the procedures were performed under sedation [n 105, 71.42%]. Indication were nephritic syndrome [NS] in 96[65.3%], secondary glomerulonephritis [SGN] in 17 [11.6%], nephritic-nephrotic syndrome [NNS] in 16 [10.9%], congenital nephritic syndrome [NS] in 15[10.2%] and others 3[2.06%]. The success and adequacy rate was 95.91% and 95.23% respectively. Failure occurred in 5[3.4%] cases. Overall, 26[17.68%] complications were observed in 21[14.28%] patients with 6[4%] being major. Technique related complications [20, 76.92%] were more than sedation/GA related [SGRC-n 6.23%]. The complications were more in sedation but the outcome was better in GA. MGT is a safe for PRB in children. The success, adequacy and complication rates in our study are in uniformity with the current standards