Frequency and shape of torus palatinus in relation to age and gender in karachi

Objective: The aim of this study was to determine the frequency and shape of torus palatinus and to assess its gender and age-related differences in the population of Karachi, the metropolitan city of Pakistan

Methodology: This was a cross sectional study with non-probability convenience sampling method conducted at Bahria University Medical and Dental College [BUMDC], Karachi. The presence of tori was observed by clinical examination and palpation. The shape was also investigated by presence or absence and classified as flat, spindle and nodular shaped tori. The data was analyzed by using Statistical Package for Social Science version 23. The Chi-square test was used to test for group differences of sex and age association with the prevalence of tori. Difference between groups with P <0.05 was considered significant

Results: A total of 1203 patients were screened in which torus palatinus was found in 141 [11.7%] patients. Present study findings showed torus palatinus was more prevalent in males 76 [53.9%]. It was dominant in 31-60 years of age group [47.5%] with significant P=0.000. Shapes of torus palatinus were compared with gender in which flat shape was more frequent in both male and female with significant P-value of 0.015

Conclusion: Torus Palatinus is a rare bony exostosis of the oral cavity. Even though, it is an asymptomatic anatomical variation it expresses itself in unique shapes and patterns. The prevalence varies with respect to age and gender

Frequency of metabolic syndrome in psychiatric patients, is this the time to develop a standardized protocol to reduce the morbidity from an acute care psychiatry unit

To determine the frequency of Metabolic Syndrome among psychiatric patients and to look for the correlation between the two medical conditions. The cross-sectional study was conducted from February to April 2013 at the acute care psychiatry in-patient unit at Kingston General Hospital, Ontario, Canada, and comprised adult patients of both genders diagnosed under the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. For Metabolic Syndrome, definitions outlined by the International Diabetes Federation were used. The patients were divided into two groups on the basis of presence or absence of the Syndrome and were compared for clinical and demographic characteristics. SPSS 22 was used for statistical analysis. Of the 50 patients in the study, 24[48%] were found to have Metabolic Syndrome. Besides, 40[80%] patients were taking atypical antipsychotics regardless of the diagnosis; 20[83%] among those with the Syndrome, and 20[77%] among those without it. Patients at high risk of developing metabolic syndrome need to be identified early so that an individualised care plan can be formulated. Identifying the variables to make a management plan is vital

Investment in paediatric tuberculosis prevention in Pakistan: loss or gain?

To assess the effectiveness of paediatric tuberculosis prevention, by reevaluation factors in children exposed to tuberculosis from less privileged strata of Pakistan. This cross sectional descriptive study was conducted at National Institute of Child Health, from January 2004 to December 2005. Paediatric patients under 15 years of either gender, diagnosed with active tuberculosis were enrolled. Interviews were conducted with parents regarding common preventive measures and factors advocating tuberculosis spread. Later factors leading to non-compliance to safety recommendations were also evaluated. Fifty five [70%] children younger than 5 years, had index cases in direct contact within their own house. Fifteen [14%] patients contracted the infection from neighbours, with 11 being older than 5 years. There were 82 [51%] cases with Protein Calorie Malnutrition [PCM]. Total of 66 [41%] cases of PCM were <5 years age [p <0.005]. Data showed 123 [77%] children living in a family with 5 or more members. Sixty eight [55%] children of these large families had to live in a single room house. There is a high frequency of direct contact tuberculosis in children belonging to the lower socio-economic class. This is attributed to poor housing condition and over crowding. The current paediatric tuberculosis prevention strategies as adapted from World Health Organizations' Millennium Development Goals are ineffectual to make changes in children exposed to tuberculosis from less privileged strata of Pakistan. Our societal and demographic factors remain static, continually exposing our children to higher risk of tuberculosis exposure

Juvenile myelomonocytic leukaemia

Juvenile Myelomonocytic Leukemia [JMML] is a rare hematopoietic malignancy of early childhood. Infection remains the principal cause of death in patients with myelodysplastic syndrome [MDS]. Sixty percent of patients are anemic and 26 percent have petechiae and/or purpura [thrombocytopenia]. Bone Marrow Transplant [BMT] is the best available treatment option. We describe the management of an eight months old male child who presented with complaints of fever, cough and pallor since six months. Despite medication his fever did not subside. He developed meningitis and intracranial bleed and expired on 11th day of hospitalization

Chediak-higashi syndrome

Chediak Higashi Syndrome is a rare inherited autosomal recessive disorder of immune system. Susceptibility to infection due to phagocyte dysfunction ranges from recurrent skin infection to over whelming fatal systemic infection. A five years old male child was admitted on 31st March 2006 with the complaints of pallor, fever and ear discharge for 6 month. He was treated by several medications but had temporary relief. The ear discharge was bilateral, foul smelling and of yellowish color. Past history was significant with episodes of abscess involving the different parts of body. Myeloid precursors shows giant, purple stained granules mainly in metamyelocytes, band cells and mature neutrophils

Acquired aplastic anemia: treatment in a developing country

The aim of this study was to evaluate the clinical presentation of aplastic anemia as well as to assess the efficacy of Cyclosporin-A in patients with aplastic anemia. This is a hospital based interventional study. During the three year study period, 44 children were enrolled. Mean age was 9.3 years and there was a male predominance. Most common clinical presentation was anemia and bleeding. Four children died before therapy was started. Cyclosporin-A was started in 40 patients. Eleven patients died before completion of therapy and three patients were lost to follow-up. Out of 26 patients who completed therapy, 11 were cured and 9 were responders while 6 were non responders according to the selected criteria. In developing third world countries like Pakistan majority of the patients with aplastic anemia cannot afford BMT. Alternative modalities of treatment must therefore be looked into. Cyclosporin-A seems to be a reasonable therapeutic option in such cases

importance of contact history in childhood tuberculosis

Tuberculosis is an ancient disease that is known to have existed in the prehistoric times, and has been a major health burden, even today 95% of the cases are present in the developing countries. The exact proportion of children with tuberculosis is unknown but it is estimated to be between 3-13% of all cases [Ejaz and Mumtaz, 2002]. The child with TB in a community will represent a failure of TB control in that community. Patients included in the study were children age between 1-15 years of either sex coming to a tertiary hospital with history, clinical and laboratory findings of tuberculosis. Diagnosis of tuberculosis was made on the basis of WHO criteria, with the support of MT, chest X-ray, clinical history and history of contact with patients of pulmonary tuberculosis. There were total 160 patients include in our study, 109 [68.1%] patients had positive history of contact from home, close relatives and from neighbors while in 51[30%] cases there was no history of contact detected

Pattern of epistaxis and its treatment modalities: the Hyderabad experience

To evaluate the pattern of epistaxis and its treatment modalities in our set up. A descriptive case series. Ear Nose Throat [ENT] department of Liaquat University Hospital Hyderabad, Sindh during years 2001 to 2003. This study comprised of 350 cases of nose bleeding managed at ENT department. Patients belonged to all ages from infancy to old, with different presentation and causes. Case records of all these cases were analyzed retrospectively. Majority of patients [63%] was male and 35.4% patients were between 16-30 years age. Bleeding due to existing nasal pathology was seen in 140 cases. Nasal trauma as a cause of epistaxis was present in 125 cases [35.7%], blood dyscrasia in 25 cases and 20 patients had metabolic disorders. Among 280 cases [80%] anterior bleeding was present. One hundred cases required immediate nasal packing to control the bleeding. Surgical procedures included nasal ploypectomy and septoplasty in 15 cases each while rhinolith and foreign bodies were removed in 15 and 25 cases respectively. Fifty cases were treated with immediate cauterization of the bleeding point. In 15 cases with malignancy of nose and sinuses, initially radiotherapy was considered to decrease the vascularity of tumors. Only 20 cases did not require any treatment except cold sponging and direct digital pressure. Epistaxis is not an ignorable emergency. It is the manifestation of multiple local and other systemic disorders. To reduce the morbidity and mortality, appropriate management is the key factor. The emergency department of all hospitals shall have proper equipment and facilities to examine and manage the cases. Cauterization of bleeding point by hot wire or chemical agent to stop the bleeding is still valuable in recurrent epistaxis

Tonsillectomy-control of haemorrhage silk ligation v/s bipolar diathermy

Control of haemorrhage during and after tonsillectomy, has always been the prime concern factor for the oto-laryngologist to minimize the morbidity and mortality since antiquity. Various techniques have been in practice for this purpose during tonsillectomy. We have used bipolar diathermy and silk sutures to control the bleeding and securing haemostasis in different cases. This is a prospective study of 120 cases of tonsillectomy conducted at ENT department, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh from January 2003 to December 2003. It is concluded that although less time is consumed when using bipolar diathermy to achieve haemostasis during tonsillectomy but however the ligation of bleeding point using silk sutures was more effective for less post operative hemorrhages