Autologous blood injection for lateral epidcondylitis of elbow

Objective: to determine the outcome after autologous venous blood injection in patients with lateral epicondylitis of elbow

Study design: descriptive case series

Place and Duration of study: Ayub Teaching Hospital Abbottabad and Saidu Teaching Hospital Swat, from August 2014 to March 2015

Methodology: patients having lateral epicondylitis of elbow were selected from the outdoor department.Two ml of autologous venous blood was drawn from the contralateral antecubital fossa of the patient and slowly injected into the site of maximum tenderness. Patients were advised to continue their normal daily activities and followed up at 2nd, 4th, 8th and 12th weeks post-procedure for assessment of intensity of pain using VAS pain score and Nirschl staging

Results: there were 38 males and 61 females with ratio of 1:1.6. The mean age was 40.91+/-8.21 year. The mean pre-injection Visual Analogue Score [VAS] and Nirschl score were 6.9+/-1.2 and 6.0+/-0.9. At follow up it decreased to 0.9+/-1.0 and 1.5+/-1.1 respectively

Conclusion: autologous blood injection is an effective way to treat patients of epicondylitis of elbow especially in refractory cases

Precocious puberty in children

To determine the etiology of precocious puberty in children and to compare the clinical and laboratory parameters of central and peripheral precocious puberty. Cross-sectional study. Endocrine Clinic at National Institute of Child Health, Karachi, from January 2009 to December 2011. Children presenting with precocious puberty were included. The age of onset of puberty was documented. Clinical evaluation, Tanner staging, height, height SDS, weight, weight SDS, body mass index, bone age, pelvic USG, plasma estradiol level and GnRH stimulation were done. Ultrasound of adrenal glands, serum level of 17 hydroxyprogesterone, ACTH, Renin, aldosterone and testosterone were performed in children with peripheral precocious puberty. MRI of adrenal glands and gonads was done in patients with suspected tumor of that organ and MRI of brain was done in patients with central precocious puberty. Skeletal survey was done in patients with Mc Cune-Albright syndrome. CAH [81.8%] indentified as a main cause in peripheral percocious puberty and idiopathic [67.74%] in central precocious puberty. Eighty five patients were registered during this period. The conditions causing precocious puberty were central precocious puberty [36.47%], peripheral precocious puberty [38.82%], premature pubarche [10.58%] and premature thelarche [14.11%]. There was a difference in the age of onset of puberty in case of central precocious puberty [mean=3, 2-6 years] versus peripheral precocious puberty [mean=5.25; 3.62 - 7.0 years]. Children with central precocious puberty showed higher height SDS, weight SDS, FSH, LH than those with peripheral precocious puberty. Etiology in majority of cases with peripheral precocious puberty was congenital adrenal hyperplasia and idiopathic in central precocious puberty. Central precocious puberty children showed higher height SDS, weight SDS, FSH, LH than peripheral precocious puberty

Pattern of dyslipidemia in adult diabetic subjects in the community hospital of district Swat

The incidence of diabetes is growing at dramatic rates around the word and its complications are associated with significant health and financial burdens, warranting strong and comprehensive prevention efforts. The objective of the present study was to evaluate the pattern of dyslipidemia in the adult diabetic patients in Saidu Teaching Hospital, Saidu Sharif, Swat. The study comprised of 100 subjects, 50 subjects with diabetes and 50 [non-diabetic] controls. The serum Cholesterol, Triglycerides, High-density Lipoprotein-Cholesterol [HDL-C] and Low-density Lipoprotein-Cholesterol [LDL-C], blood sugar [random and fasting], blood pressure [systolic and diastolic] of Diabetic subjects were compared with Control subjects. Diabetic subjects had high mean value of Triglycerides and LDL-C [but statistically nonsignificant], low level of HDL-C [statistically highly significant] and high blood pressure as compared to Control subjects. Dyslipidemia is a potent predictor of cardiovascular morbidity and mortality in diabetic patients

Maternal factors associated with intrauterine growth restriction

Intrauterine growth restriction is a major neonatal health issue. Maternal factors have been found to have greater impact on IUGR. Studying these factors can help in reducing the mortality and morbidity associated with IUGR. This Case-control study was conducted at the department of Paediatrics Post-graduate medical institute Lady Reading Hospital Peshawar from March 2008-April 2009. Small-for-gestational age [SGA, i.e., IUGR cases and n=200] live born babies were compared with appropriate-for-gestational age [AGA, i.e., controls and n=200] babies. Information regarding socio-demographics of mothers, gestational age and birth weight of baby, maternal clinical characteristics, and medical and obstetric complications during pregnancy was recorded on a predesigned proforma. Data analysis was done through SPSS-16. To find the maternal factors associated with the intrauterine growth restriction, multivariable logistic regression was used. We also did two different sets of logistic regression analysis for Symmetric and Asymmetric SGA babies as Cases. After adjusting for other variables in the multivariable model we found that the mothers of IUGR babies were of younger age [OR=0.8, CI=0.7-0.9], were poor [OR=2.5, CI=1.4-4.4] and underweight [OR=3.5, CI=1.1-5.7] and had anaemia [OR=2.7, CI=1.3-5.4] in the index pregnancy, and had history of Previous IUGR birth [OR=9.7, CI=3.3-18.3] and placenta previa [OR=3.2, CI=1.1-6.6]. There was an interaction between pregnancy induced hypertension and parity of mother with a primary-para mother with pregnancy induced hypertension [PIH] having an increased risk for IUGR babies [OR=10.1, CI=1.0-23.2]. The studied factors need special attention in hospital based settings in order to improve the perinatal outcome in IUGR babies

Frequency of ABO and Rhesus blood groups in district Swat, Pakistan

Up till now about 400 red cells antigen have been identified. The majority are inherited by Mendelian Fashion. The ABO blood group system was first to be identified and RH blood group system was the 4th one, both are most important for blood transfusion purposes. This study is conducted to determine the frequency of ABO and Rhesus [Rh] blood groups in District Swat, NWFP, Pakistan. It is a cross sectional prospective study and was conducted at Saidu Teaching Hospital district Swat, over a period of one year. [1[st] Jan, 2007 to 31[st] Dec, 2007]. A total of 22897 subjects were included in this study. Patients were collected from different wards of Saidu Teaching Hospital while the donors from common population. From each subject blood was collected, ABO and Rh blood grouping were carried out by tile method using commercially prepared anti sera. The frequency of each type was calculated. Out of 22897 subjects 17141 [74.86%] were male subjects and 5756 [25.14%] were female. Out of 17141 male subjects 15597 [90.99%] and out of 5756 female subjects 5040 [87.56%] were found to be Rh-positive. The frequency of Rh-negative group in male subjects were [9.01%] where as in female subjects were [12.22%]. The frequency of A, B, O and AB groups in Rh-positive male subjects were 25.63%, 29.54%, 26.04% and 9.78%, amongst female subjects, it was 24.53%, 28.06%, 25.54% and 9.43% respectively. In Rh-negative male subjects the frequency of A, B, O and AB is 2.25%, 2.88%, 3.01% and 0.88%, while amongst females it is 3.54%, 4.24%, 3.74% and 0.92% respectively. It is concluded from this study that frequency of Rh-positive blood group is B, O, A, and AB in both gender. Where as the most common Rh-negative in male and female subjects are O, B, A, AB, and B, O, A, and AB respectively