Risk factors associated with childhood asthma among children aged 1-12 years in Rawalpindi

To explore various risk factors associated with childhood asthma in Rawalpindi garrison and city among children 1-12 years old. Case Control study. Pediatric departments of Military Hospital [MH] and Combined Military Hospital [CMH] Rawalpindi from 1st Aug to 30th Nov 2009. A total of 128 children with diagnosis of asthma presenting in outpatient and indoor pediatric departments of MH and CMH Rawalpindi between ages of 1-12 years were included. Age, gender and socioeconomically matched 112 children without diagnosis of asthma were included as controls. A predesigned questionnaire containing various factors associated with childhood asthma was filled by the researcher by detailed interview with either of parents. Data was analyzed by SPSS version 15 and chi-square test was applied to determine significance. p value <0.005 was considered significant. Out of 15 risk factors studied 8 were found significantly associated with childhood asthma. Significant factors were education of any of the parents more than matric, history of fever at least three times in last year, use of antibiotics, history of hay fever, raised IgE levels, exposure to passive smoking, living in urban areas and family history of asthma [p value<0.005]. Non significant factors were mode of delivery, exclusive breast feeding for more than 3 months, partial breastfeeding for more than 6 months, history of eczema, atopy, history of viral respiratory infections in infancy and less than three number of rooms at home. Male preponderance was noted amongst cases. Education of parents, fever, antibiotics, hay fever, raised IgE levels, exposure to passive smoking, living in urban areas and family history of asthma proved to be significant factors which are similar to those reported in other studies. However, difference was found in other factors. Recognition of these factors can help to optimize management of asthma in children in this area

Gall bladder carcinoma with krukenburg tumour a case report

To determine the mechanism and pattern of animal related injuries in the troops deployed in field. A hospital based observational study. Main Dressing Station Kotli Azad Kashmir from Jan 2004 to Jan 2006 An observational hospital based study was carried out on all the patients who reported to the Main Dressing Station [MDS] between Jan 2004 to Jan 2006. The data was collected by using hospital information system. A performa was developed after review of literature which included necessary information related to patient's age, sex, type of injury and species of animal involved. The information collected was analyzed in detail. Laskin and Donhoue1 classification was used to classify wounds. A total of 48 patients were reviewed. These were all males and the mean age was 25 years. Thirty three [69%] patients had soft tissue injuries, 7 [15%] had fractures, 5 [10%] had head injury and 3 [6%] had abdominal injury. Mule kick injuries occurred in 37[77%] patients, dog bite in 7[15%] cases and donkey bite in 4[8%] cases. Troops deployed in the field are exposed to the hazard of animal related injuries which can be fatal at times. The complex nature of these injuries entails early and appropriate management in order to achieve satisfactory outcome and prevent complications. Prevention strategies include proper animal handling techniques based upon animal behavior and the appropriate use of well designed confinement facilities

Etiology of short stature in children

To determine the causes of short stature in children with special emphasis on growth hormone deficiency. Case series. Department of Paediatrics, Military Hospital, Rawalpindi and Combined Military Hospital, Multan from September 2004 to January 2007. Two hundred and fourteen children [140 boys and 74 girls], ranging from 02 to 15 years presenting with short stature were studied. Height and weight were plotted on appropriate growth charts and centiles determined. Relevant hematological and biochemical investigations including thyroid profile were done. Bone age was determined in all cases. Growth hormone axis was investigated after excluding other causes. Karyotyping was done in selected cases. Data was analyzed by SPSS 10.0 by descriptive statistics. Mean values were compared using t-test. In this study, the five most common etiological factors in order of frequency were Constitutional Growth Delay [CGD], Familial Short Stature [FSS], malnutrition, coeliac disease and Growth Hormone Deficiency [GHD]. In 37.4% of patients, the study revealed normal variants of growth - CGD, FSS or combination of both, 46.7% cases had non-endocrinological and 15.9% had endocrinological etiology. CGD [22.1%] in males and FSS [27%] in females were the most common etiology. GHD was found in 6.1% children and it comprised 38.2% of all endocrinological causes. Children with height falling below 0.4[th] centile were more likely to have a pathological short stature [79.2%] compared to 39.3% whose height was below 3rd centile but above 0.4[th] centile [p<0.05]. CGD and FSS are most common causes of short stature in boys and girls respectively, whereas, GHD is a relatively uncommon etiology

Leigh disease-a rare mitochondrial neurometabolic disorder

Clinical presentation of Leigh's disease can be highly variable. We present here this case which presented with quite bizarre neurological symptoms and signs in early infancy and was suspected on the basis of CT scan findings which was further supported by high serum lactic acid levels

Relationship of blood group AYE with ischemic heart disease

To see the relationship between blood group AYE and ischemic heart disease. This was a case control study done at Armed Forces Institute of Cardiology [AFIC]/ National Institute of Heart Diseases [NIHD] from 1[st] July 2001 to 30[th] June 2003. Blood groups of all patients undergoing bypass surgery were recorded. The controls were the blood groups of all angiography negative cases from the same institute for the same period. Total of 1196 cases and 1196 controls were selected on 1:1 ratio. Out of 1196 cases, 519 [43.4%] were of AYE phenotype blood group [486 Aye positive and 33 Aye Negative], 369[30.8%] were BEE, 251[21.98%] were OOO, 57 [4.76%] were AB phenotype blood group. On computing the strength of association of blood group with the IHD, it was found that persons having blood group AYE have 3.34 times more chances of developing IHD than other blood groups. The difference was highly significant [P < 0.0001]. Out of 1196 controls, 223 [18.67%] were of blood group AYE [201 Aye positive and 22 Aye Negative], 468 [39.19%] were of blood group BEE, 432 [36.18%] were of Blood Group OOO, and 72 [6.03%] were of blood group AB. Being an important risk factor it is recommended that Blood Group AYE should be included in Non modifiable risk factors of ischemic heart disease

Hospital waste management in a tertiary care army hospital

This direct observational descriptive study was carried out in a tertiary care army hospital from 5th December 2003 to 19th December 2003 to assess its prevailing practices of health care waste management and to estimate hospital waste generated per bed per day. Presently the waste is being segregated and collected in different colour coded receptacles only at the nursing stations and carried in open unhygienic trolleys. The sanitary workers were not using protective devices while handling waste in the hospital. The waste generation was calculated by placing coloured receptacles in selected zones and constant observation for seven days each as mentioned above. Results showed that total waste generation was about 3.434 kg/bed/day [out of which 0.309 kg was infectious, 0.103 kg sharps and 3.022 kg non- infectious] and that final disposal of infectious and non-infectious waste was getting mixed-up while loading in the municipality carriage system. The awareness of sanitary workers regarding colour coding was fair but not up to the mark and they were also unaware of potential hazards of health care waste while handling it. Eighty one percent of sanitary workers were vaccinated against tetanus and typhoid but none of the 86 workers were vaccinated against Hepatitis B. Two single chambered, brick made, gas fired so called [incinerators] with enormously low temperature are being used for burning which are emitting smoke and obnoxious gases directly into the atmosphere, affecting the health of the people and environment. Liquid waste is thrown down the municipal sewerage system without any prior treatment, which is adding up to the water pollution. The study concluded that although some basic steps have been taken towards the effective waste management but still there is a long way to go. Several recommendations have been made to stream line the waste segregation, collection, transportation and final disposal along with the improvement in the awareness of sanitary workers about the potential hazards of health care waste and to get 100% vaccination against tetanus, typhoid and hepatitis B. In the end it is also recommended that national guidelines on hospital waste management must be practically implemented without any further delay