Effect of organophasphate poisoning among patients reporting at a tertiary healthcare facility of Sindh Pakistan

Objective: To determine the effect of organophosphate poisoning [OPP] among patients at tertiary healthcare, Pakistan

Methods: This cohort study was conducted over a six-year period [January 2011 to December 2016] of OPP patients admitted to the intensive care unit of Peoples University of Medical and Health Sciences for Women SBA, Hospital Pakistan and their outcome was determined

Results: Total mortality was 17.39% [84 deaths in 483 patients, excluding those referred to Karachi]. Out of these 84 deaths, 65 patients [13.46%] expired due to cardiorespiratory failure, 17 deaths [3.52%] followed due to complication of mechanical ventilation and ICU acquired infection and two deaths [0.41%] occurred due to renal failure. The major cause of poisoning was deliberate self-harm /suicidal intention [93.02%], with gender distribution of female [57.07%] and male [35.95%], followed by unintentional/accidental exposure [6.98%] in males. The intensive supportive treatment, precise and appropriate respiratory care, and adequate amount of atropine and pralidoxime doses are keys to reducing the OPP patient's mortality

Conclusion: Organophosphate poisoning [OPP] intoxication is common in female gender. The easy availability of these harmful compounds has resulted in increased mortality either by accidental exposure or most often by the deliberate suicidal attempt

Guillain Barre syndrome [GBS], the leading cause of acute flaccid paralysis at peoples medical college hospital Nawabshah

To identify and treat the acute flaccid paralysis in interior of Sindh reported at PMCH Nawabshah. Retrospective, with proper date and record. Medicine and ICU Department at Peoples Medical College Hospital Nawabshah from 31[st] January to 31[st] October 2009. Patients of all 3 medical units were involved in the study during this period. 50 patients with acute flaccid paralysis [AFP] were admitted in Intensive Care Unit of Peoples medical college Hospital Nawabshshah with support of all emergency measures and were evaluated. 50 patients presented with AFP during study period. 40 were males and 10 were females. GBS was the leading cause of AFP. Majority of the patients were young, out come was excellent. 2 patients died due to respiratory failure. GBS is the leading cause of AFP in adults in interior of the Sindh while facilities for treatment are limited, which need to be extended in the hospitals situated in interior of Pakistan i.e. ICU and plasmopharesis

Asymptomatic spontaneous bacterial peritonitis in liver cirrhosis with ascitis

To asses the frequency of asymptomatic spontaneous bacterial peritonitis in liver cirrhotic patients with first presentation of ascities. A descriptive case series study. This study was conducted at the Department of Medicine, Peoples Medical College Nawabshah from 1st September 2007 to 28th February 2008. In this study 100 patients of cirrhosis with ascities. There were 52 [52%] females and 48 [48%] males. Detailed history was taken from all the patients. The diagnostic criteria were the presence of sign and symptoms of chronic liver insufficiency e.g pallor, jaundice, clubbing, palmar erythema, gynecomastia, spider navie, visible veins, splenomegaly, edema or ascities etc. Laboratory investigations include CBC, LFTs, PT, total protein, Ascitic fluid D/R etc. and specific investigations especially ultrasound of abdomen as diagnostic modality and for assessment of cirrhotic patients with ascities. All patients fulfilling the inclusion criteria. Age ranging from a minimum of 20 years to 80 years with mean ages of patients was 44.99 +/- 14.29 years. There were 52 [52%] females and 48 [48%] males. Twenty one [21%] patients positive for spontaneous bacterial peritonitis because of WBC >/= 500 and neutrophils >/= 250 /mm[3] while 79 [79%] patients who had WBC >/= 500 and neutrophils

23 +/- 4.4. In this study clearly showed a high percentage of asymptomatic SBP in cirrhotic patients with ascities. This is quite high in comparison with national and international studies. Thus in future studies should be conducted determining the factors associated with high frequency

Chronic suppurative otitis media: microbial profile in the rural sindh

In this study the tubo-tympanic variety has affected the pre-school and school going children although there was no bacteriologically significant difference in different age groups. Different anaerobe isolates include Bacteroides species [17.82%], Bacteroides melaninogenicus [11.60%] and Bacterioldes fragilis [06.22%] and anaerobic gram-positive cocci [07.56%], Peptostreptococcus [06.67%], Peptococcus [0.89%], while in mixed infections the Pseudomonas species was the most common isolate [27.78%], Proteus mirabilis [12.00%], Proteus vulgaris [0.89%], followed by aerobic gram-positive Staphylococci [10.22%] and Diphtheroids [12.00%]

Granulomatous hepatitis: Analysis of twenty seven patients

Granulomatous hepatitis is a non-specific condition with different infective and non-infective aetiologies. This study was conducted on 27 patients of granulomatous hepatitis, to define aetiology, collected from different hospitals of Karachi and Peoples Medical College Hospital, Nawabshah. Tuberculosis was the common diagnosis, found in 24 [88.9%] patients, two [7.4%] had sarcoidosis while primary biliary cirrhosis was seen in one [3.7%] case only. Sex distribution showed female preponderance with 16 [59.23%] cases