ABSTRACT
Introduction: Myeloid malignancies are clonal disorders of hematopoietic stem/precursor cells. The criteria for the diagnosis of acute myeloid leukemia [AML] are based on morphological cytogenetic and flow-cytometric findings. The prognostic outcome with intensive chemotherapy is better than with non-intensive treatment
Purpose/Objectives: To determine the frequency of various clinical and pathological findings in myeloid malignancies
Study Design: Cross sectional descriptive study
Place and Duration of Study: The study was carried out at Department of Pathology from October 2014 to December 2016
Material/Patients and methods: Detailed history, clinical and pathological findings recorded on a pre-designed proforma including bone marrow reports was evaluated
Results: During period of study, 351 proformas including bone marrow reports were evaluated, from which 49 [30 males and 19 females; age ranges between 03 months to 60 years] were diagnosed as myeloid malignancies. The distribution of myeloid malignancies were acute myeloid leukemia [n=21], chronic myeloid leukemia [n=14], acute myelodysplastic syndrome [n=3], myeloproliferative neoplasms [n=3], myelofibrosis [n=2], myeloid hyperplasia [n=2], acute promyelocytic leukemia [n=2], myelomonocytic leukemia [n=1], ,and transient abnormal myelopoiesis [n=1].The main presenting complaints were fever and weight loss, whereas splenomegaly was the most common finding on clinical examination. The commonest laboratory finding was anemia followed by leukocytosis; while 10 patients showed pancytopenia
Conclusion: AML with fever and bicytopenia is the commonest myeloid malignancy in our series
ABSTRACT
Background: Tuberculosis [TB] in children is clearly linked to TB in adults therefore active household contact tracing is an important method of early diagnosis and treatment particularly in high-TB-burden countries
Objectives: To estimate the prevalence of TB among household contacts of children suffering from tuberculosis using active contact tracing and linking them to TB program for treatment
Subjects and Methods: A total of 125 children suffering from active tuberculosis [index cases] aged 12 years or less were randomly selected from the outpatient department of a tertiary care hospital of Hyderabad. Using their home address, all house hold members of the index cases [sharing one kitchen] were identified. The households were visited by a team including a doctor and the supported staff and were screened for TB using history, physical examination, sputum for AFB and X-ray of chest. Clinical suspects were divided in to two populations, equal to or less than 12 years of age and greater than this age. All suspected cases were brought to outpatient's department of the hospital where children were examined and diagnosed by pediatrician and adults were examined by the pulmonologist
Results: There were 125 children and 1365 household members. Prevalence of active TB in adult household contacts was 8.1% and among children was 5.7%. Mother, father, grand parents or siblings were the source of disease spread in children. Family history of TB was present in 95% [pulmonary 78%, extra-pulmonary 22%]
Conclusion: Tuberculosis in children is mostly spreading from household member hence deeply required to undertake active contact tracing in each new case that is diagnosed or being treated
Policy message: National and Provincial TB programs should advocate and undertake active screening of all household contacts of all TB cases
Subject(s)
Child , Child, Preschool , Female , Infant , Infant, Newborn , Humans , Male , Tuberculosis, Pulmonary/prevention & control , Contact Tracing , Child , Cross-Sectional Studies , Tertiary Care CentersABSTRACT
Objective: To evaluate the effect of parent's education and better schooling in achievement of medical entrance exam
Design: Descriptive
Setting: Department of Anatomy, Liaquat University of Medical and Health Sciences, Jamshoro
Method: This study was conducted on first year MBBS students admitted in Batch 2015-2016 at Liaquat University of Medical and Health Sciences Jamshoro. Total 340 students were included in this study. A questionnaire is used for data collection which was filled by students after verbal consent
Results: Out of total 340 students, 314 filled the questionnaire. Among 314 students 111 [35%] are males and 203 [65%] are female students. Eighty percent [80%] male and eighty five percent [85%] female students had their early education from private schools of high standard while only 20% male and 15% female students had their education from government/ public schools. Regarding parental education, female students has 100% fathers and 89% educated mothers, while for male students 97% fathers and 69% mothers found educated. Overall 90% parents who were educated
Conclusion: Although there may several factors, however better schooling and parental education is most powerful factor to influence success rate of children pre medical entrance exam
ABSTRACT
OBJECT: Two easy methods for the diagnosis of h pylori i.e: Serum Anti H Pylori Antibodies and Stool Antigen
MATERIALS AND METHODS: Hundred serum and stool samples collected from the department of surgery, and Medicine were registered at Department of Pathology and Diagnostic and Research Lab LUMHS, Jamshoro/ Hyderabad for performing H. pylori diagnosis were included in this Study. Patients of all age groups and both sexes with complain of dyspepsia, or having the linical suspicion of H. pylori associated gastritis were included. Patients having H/O NSAIDs, or eradication therapy were excluded. A specially designed proforma was used for recording the relevant data. The Period of study was 15-10-2009 to 28-02-2011
RESULTS: From 100 cases of, H. pylori antibodies were found in 68 [68 %]. 38 [55.9%] were male and 30 [44.1%] were females. Sensitivity of this technique was 75.55% and specificity 60%. P value 0.007. From stool samples collected from 100 patients H. pylori antigen were positive in 48 [48%] cases detected on immunochromatography technique. Stool antigen positive was in 28 [58.3%] males and 20 [41.7%] Female patients. The stool antigen sensitivity was 52.74% and specificity 90% P value [0.011]
CONCLUSION: H. pylori positivity is highly significant in histological examination of endoscopic biopsies on H and E and Giemsa Stains The detection of anti H. pylori antibodies from serum by ELISA method and the H. pylori antigen from stool samples by immunochromatographies method, can be non invasive simplest, least expensive and alternatives in patients unwilling for endoscopy
ABSTRACT
OBJECT: To find out the frequency of H.pylori infection in patients undergoing upper GI endoscopy
MATERIALS AND METHODS: This study was conducted at surgical unit-I Liaquat University Hospital and private hospital located at Hyderabad Sindh from June 2010 to July 2011. After taking written consent those Patients were enrolled who fulfilled the inclusion criteria. Study was approved by ethical committee. Presence of H.pylori infection was confirmed by histopathological examination of samples taken during upper gastrointestinal endoscopy. Presence or absence of gastritis was also observed. GIF 140 Olympus gastro-video-scope was used for the procedure
RESULTS: 165 patients were enrolled in the study, among them 82 were males and 83 females with mean age 41.04 +/-15.9 and 35.9 +/-11.5 years respectively, among males 43 [52.43%] were positive and 39 [47.5%] were negative for H.pylori infection, while in females 38[45.78%] were positive and 45 [54.2%] negative for the same. When compared for gender differences there was slightly higher prevalence in males. Antral Gastritis was common association with H.pylori infection in both genders with higher prevalence in males as compared to females. 5 patients [5%] were found to have gastric carcinoma without any H.pylori association CONCLUSION: Helicobacter pylori infection is quite frequently found in association with gastritis in males as well as females with slightly higher prevalence in male
ABSTRACT
Objective: To determine the etiological factors, complication[s] and prognosis of patients suffering from liver cirrhosis in our setup. Design: Cross-sectional study. Setting: Medical and surgical departments of Liaquat University Hospital Hyderabad/ Jamshoro, Sindh - Pakistan, from April 2005 to April 2007
Methods: Patients having an evidence of cirrhosis of liver on ultrasound examination of abdomen were enrolled. All those patients who were not confirmed to be cirrhotic, excluded from this study. All cases were studied to determine the etiological factors, complications and prognosis of disease. All data were recorded on a proforma. Patients with acute variceal hemorrhage were referred to surgical department for endoscopic sclerotherapy or variceal band ligation
Results: Total 100 patients were studied, 67[67%] males and 33[33%] females. Their mean age was 53.09 with SD= 8.85814 years. Majority of patients, 52[52%] had HCV infection, 16[16%] had HBV infection, 16[16%] had HBV and HCV co-infection, 08[08%] had alcohol abuse, 01[01%] had primary biliary cirrhosis, 02[02%] had Wilson's disease and no etiological factors were recorded in 05[05%] patients. Ascites was present in 59[59%] cases, portal hypertension in 42[42%], esophageal varices in 29[29%], spontaneous bacterial peritonitis in 29[29%], acute variceal hemorrhage in 27[27%], hepatic encephalopathy in different grades in 24[[24%], hepatorenal syndrome in 09[09%] and hepatocellular carcinoma in 07[07%] patients. All patients with acute variceal episode[s] were adequately and timely treated in surgical department. When cirrhotic patients were grouped into child-Pugh's classification, 37[37%] were in class 'A' category, 37[37%] in class 'B' category, and 26[26%] in class 'C' category
Conclusion: HCV infection is the major risk factor for cirrhosis in our setup. Ascites was the commonest complication. Patients with child-Pugh's class 'A' cirrhosis had significantly longer survival than patients with child-Pugh's class 'B' and 'C'. A multidisciplinary approach for prevention and control of ever increasing HCV infection must be adopted and to make the public awareness through the mass media about its drastic complications, and possible modes of its transmission
ABSTRACT
Objective: To assess the role of laparoscopic cholecystectomy [LC] in gallstone disease with its complicated problems. Design: Prospective observational study. Setting: Surgical Department of Liaquat University of Medical and Health Sciences, Jamshoro and Private Hospitals of Hyderabad, Sindh-Pakistan; from May 2001 to April 2005
Methods: The patients were categorized as cases of complicated gallstone disease on the basis of clinical assessment, investigations especially ultrasound abdomen and operative findings noted during laparoscopic cholecystectomy. All patients were explained for advantages and disadvantages of early LC with their difficult disease problem and willing taken for study. Sampling strategy was convenient. The patients with uncomplicated gallstones, obstructive jaundice, acute pancreatitis and carcinoma of gall bladder were excluded from this series
Results: 120 out of 400 patients presented with one of the known complication of cholelithiasis such as chronic cholecystitis 50%, acute cholecystitis 12.5%, empyma 18.33%, mucocele 10% and fibrosed gall bladder in 9.17% of cases as assessed on clinical examination, ultrasound and laparoscopic findings. Majority [75%] of cases were having adhesions around gall bladder and 25% without adhesions. Problems encountered during LC were difficult separation of tight adhesions around gallbladder [50.0%], grasping and holding of thick walled and distended gallbladder [41.67%], dissection and identification of structures in Calot's triangle [29.17%], haemorrhage from main cystic artery and gall bladder bed 20.83% and delivery of large and thick wall gallbladder in 25% of cases. Intra operative complications seen during procedure were haemorrhage in 20.83% cases, perforation of gallbladder by instrumentation in 12.5% and avulsion of cyctic duct in 1.67% of cases. Two patients [1.67%] were converted to open cholecystectomy due to bleeding. Postoperatively 12.5% of patients developed biliary leak, out of which 3 cases [2.5%] were due to actual common bile duct injury, 2.5% of cases developed port-site sepsis as main postoperative complications. Cases with bile duct injury were re-explored and managed accordingly. Hospital stay varied from 2-7 days but majority of patients were discharged [70.83%], within 2-3 days, no mortality was seen in this series
Conclusion: Laparoscopic cholecystectomy like uncomplicated biliary stone disease is equally effective procedure for complicated cholelithiasis. Its applicability is almost 95% in experienced hands