ABSTRACT
Background: Thalassemias are a group of genetic blood diseases. These patients are blood transfusion dependent because of genetic inability to produce hemoglobin according to body needs. Due to repeated transfusions, these patients are vulnerable to HCV, HBV and HIV like blood transmitted diseases. The purpose of this study is to determine post transfusion HCV frequency in these patients
Objective: To assess prevalence of antibody HCV in multi-transfused Thalassaemia patients. Study Setting: The study was conducted at Thalassaemia Center, DHQ Hospital Faisalabad located in Central Punjab, Pakistan. The record of the Thalassemia children registered in this center during 1[st] Jan 2012 to 31[st] Dec 2014 was reviewed. Study Design
Methodology: A descriptive cross sectional study was conducted on 416 Thalassemia children registered in Thalassemia Center DHQ Hospital Faisalabad. Out of these 379 children were included while 37 excluded due to incomplete record. The demographic data, blood transfusion history and lab tests details were taken from patient files. The HCV diagnostic laboratory techniques used were Rapid manual, confirmed by Enzyme Linked Immunosorbent Assay [ELIZA]
Results: Out of 379 Thalassemia patients, HCV positive found were 123 [32.45%]. The study population age was in range of 1- 19years while age range of HCV affected group was 5-19 years. Out of total 379, male were 235 [62%] and female were 144 [38%] while in total 123 HCV affected group 82 [66.67%] were male and 41 [33.33%] female. In total of 379 Thalassemic children having multiple transfusions, 123 [32.45%] were HCV +ve. Among 353 Thalassemic children having positive blood groups, 111 [31.44%] were HCV +ve while 12 [46.15%] were HCV +ve in 26 children with negative blood groups. Among 235 male, 82 [34.89%] were HCV +ve and 41 [28.47%] HCV +ve in 144 female children. Hepatomegaly was 75% in HCV +ve while 65% in HCV -ve groups. The splenomegaly was almost 80% in all groups
Conclusion: Despite use of screened blood transfusions in this center, still there is alarming proportion of HCV affected blood receiving patients. In this study Antibody HCV prevalence was higher [46.15%] in Thalassemic children with negative blood groups than [31.44%] positive group children. In total HCV +ve patients, 2/3 [66.67%] were male and 1/3 [33.33%] female group. This study warrants attention to improve HCV diagnostic and instrument sterilization techniques to minimize the risk of HCV infection
ABSTRACT
Background: Road Traffic Accident [RTA] is growing public issue and fall among four top causes of mortality and morbidity. Many people [of all age groups], die daily during playing in streets or travelling on roads. Main causes of these accidents are lack of driving skills, distracted and prolonged driving, use of intoxicants, use of mobile phone during driving, defective roads, over loading and inadequate government administrative structure. These accidents are predictable and largely preventable through multi-disciplinary coherent strategies
Objective: To study epidemiological factors, compliance with traffic rules and pattern of accidental injuries
Methods: This study is descriptive cross sectional, carried out at DHQ Hospital Faisalabad. The data was obtained from patients of RTA arriving at Accident and Emergency Department [Trauma Center], from 1[st] January 2016 to 30[th] June2016. During this period 583 patients of RTA were reported to this center. The study variables were socio demographic, human, environmental and time factors. Statistical analysis was done in percentages, linear / logarithmic trends and chi-square test to know strength of association between these variables
Results: Among total 583 RTA cases, male victims were 449 [77.02%] and female 134 [22.98%]. Majority of cases 256[43.91%] were in age group of 15-29 years. Victims of RTA from rural areas were 194 [33.28%] while 389 [66.72%] were from urban / sub-urban areas. People from low economical strata were 198 [33.96%], moderate 310 [53.17%] and victims with illiteracy level were 135 [23.16%] and having education up to school were 304 [52.14%]. Human factor, cell phone user were 29 [4.97%]. Victims observing traffic rules were 93 [15.95%] while only 17 [30.19%] practiced PPM. Human factor regarding casual attitudes was observed in 47 [8.06%] cases. Maximum accidents occurred during office/school and market opening / closing timings i.e. 08-00 to 12-00 hours, 180 [30.87%] with fatality 27 [04.63% of this time events and 24.12% of total fatality] and 12-00 to 16-00 hours 136 [23.33%] with 4.29% fatality of total events and 22.32% of total fatality]. Fatality was maximum during evening, 35 [6.00%] of evening RTA's and 31.25% of total fatality. Environmental factors, worst weather was observed in 35 RTA's [6.00%], narrow and repairable roads shared in 69 cases [11.84%] while in old repairable vehicles were 17 [2.92%]. RTA in two wheeler vehicles/one wheeler were 271+59=330 [56.60%], in auto rickshaw [three wheeler] 106 [18.18%] and in pedestrian 85 [14.58%]. Pattern of head injury was found in 72 RTA's [12.35%] while limb injuries 76 [13.04%]. Mortality occurred in 112 [19.21%] cases while mild to severe morbidity was observed in 471 [80.79%] cases
Conclusion: This study concluded that male youth shared major portion of RTA victims. Morbidity and mortality was high in riders of two wheelers and in persons having head injuries. All the contributory factors were largely preventable through multi-pronged approach
ABSTRACT
Objective: to study the clinical and laboratory parameters of children extubated from ambu bag and endotracheal tube after being manually ventilated for at least more than 24 hours
Methods: various clinical and laboratory parameters were evaluated initially at the time of intubation and then at the time of extubating. The clinical parameters evaluated included the heart rate and respiratory rate, Glasgow coma scale, spontaneous respiratory effort, respiratory distress and pupillary reaction. The Laboratory parameters evaluated included TLC, CRP, and arterial blood pH, HCO3, PO2 and PCO2, CXR, flow rate of oxygen required to maintain oxygen saturation and the dose of cardiac support in the form of dopamine infusion
Results: total 24 patients were included in the study, 11[46%] male and 13[54%] female. Age range was from 0 to 36 months with mean of 6.5 months. The mean values of Laboratory parameters at the time of intubation included a pH of 7.13, HCO3 17, 02 sat 64, PCO2 52, and rate of oxygen flow 3.5 liters/min. The mean values of same parameters at the time of successful weaning were, pH 7.36, HCO318, 02 sat 94, PCO2 29, and rate of flow of oxygen 3.5 liters/min. Regarding clinical parameters the mean value for GCS at intubation was 5 which later improved to 13 at extubating. Similarly the pupillary reaction at intubation showed constriction of pupils in 6[25%] and mid-dilated with sluggish reaction in remaining 18[75%], while almost 95% cases had reactive pupils at extubating
Conclusion: ambu-bagging though crude but is a successful tool for respiratory support in the absence of ventilator. Clinical and lab parameters can predict the outcome in children who are solely intubated and ve11tilated by ambu bag
ABSTRACT
Objective: to assess frequency of various clinical presentations of dengue fever in pediatric age group at a tertiary care hospital in Lahore
Methods: a cross sectional survey was conducted from Dec 2012 to Sep 2013 in pediatrics department of Jinnah hospital Lahore. 150 patients were enrolled as per inclusion criteria. Clinical features were abstracted on a standardized Performa and investigations were done, including complete blood count, hematocrit, anti-dengue lgM [If fever more than 5 days], NS1 antigen [If fever less than 5 days] by Elisa and ultrasound scan of abdomen to document free fluid in abdominal or thoracic cavity. Data was analyzed using SPSS Version 17
Results: one hundred and fifty patients with mean age of 8.4 years [SD of+/- 2.8 years] were enrolled. 86 patients [57.3%] were males with male to female ratio of 1.3: 1. High grade fever was present in all the 150 patients [100%] and Diarrhea in 21[14 %] patients. Other clinical features included: petechial in 25 [16.3%], epistaxis in 20 [13.3%], hematemesis in 8 [5.3%], hepatomegaly in 33[22%] and splenomegaly in 15 [10%] subjects. The evidence of dengue hemorrhagic fever was seen in 23 patients [15 %], while there was no case of Dengue Shock Syndrome
Conclusion: most of dengue fever cases were from 5 to 10 years of age group. High grade fever was the most common clinical manifestation of dengue fever, followed by hepatomegaly, petechial, diarrhea, epistaxis, splenomegaly and hematemesis. Dengue fever was more common in males as compared to females, and about one in six cases had dengue hemorrhagic fever
ABSTRACT
Objective: To evaluate the validity of 50 g oral Glucose Challenge Test as a screening tool for GDM in our population
Materials and Methods: This cross sectional study was carried out in Obstetrical clinic, Combine Military Hospital [CMH] Lahore. 100 women carrying singleton pregnancy between 20-35 years of age, booked in first trimester were included while patients with risk factor of GDM or with established type I or II DM were excluded from study. 50 g GCT was administered to patients between 24-28 weeks of gestation after informed consent. Venous plasma glucose levels after 1 hour of glucose load, were taken, using 140 mg/dl as a cut off value. Regardless of results of screening, all patients were tested with 100 g OGTT as a gold standard of diagnosis of GDM.. Validity of 50g GCT was calculated for sensitivity, specificity, positive and negative predictive value. Data was analysed by SPSS version 16
Results: Out of 100 patients, 19% were screen positive and 81% screened negative with 50g GCT. With100 g OGTT, true positive were 10 out of 19[52.6%] screen positive, and false positive were 9 out of 19[47.4%] screen positive. False negative were 3 out of 81[3.7%] screen negative, whereas true negative were 78 out of 81[96.3%] screen negative. Validity of 50 g GCT has been calculated to be having sensitivity of 76.92%, specificity of 89.6%, positive predictive value of 52.6% and negative predictive value of 96.2%
Conclusion: 50 g GCT is an effective screening tool for GDM between 24-28 weeks of gestation with adequate sensitivity and specificity
ABSTRACT
Objective: to assess Knowledge, Attitude and preventive measures practiced by semi-urban / rural adult population of central Punjab regarding dengue fever
Study setting: independent University Hospital Faisalabad located in semi urban area of Jinnah Town [District Faisalabad] was selected for this study
Study Design: a cross sectional Descriptive study was conducted among the adult patients and their attendants from semi-urban/rural area attending OPD IUH
Study Population: adult patients/their attendants aged 18 years and above from both sexes and from all economical strata attending OPD of IUH were asked to take part in the study
Materials and Methods: Inclusive criteria: participant should be residing in Jinnah Town Faisalabad for the last one year
Sample Size: 550 adult individuals were taken by convenient sampling from the OPD patients and their attendants of IUH as a representative sample of total population of Jinnah Town. 95% confidence interval, 5% sampling error, assumption of 50% knowledge and attitude prevalence and 15% non-response rate were decided prior to study
Results: 550 individuals were enrolled for study, 50 participants decline to continue study. Analysis showed that 83.8% participants have adequate knowledge about vector, 38.6% know about dengue fever, 83.2% have good attitude about dengue fever, 86.6% participants use some of the preventive measures to protect themselves from mosquito
Conclusion: more Awareness Campaigns regarding dengue fever are still needed in rural area to have adequate level of KAP to control and prevent dengue fever epidemics. Due to low literacy level, there is gap between knowledge and practices. Health services in rural areas are insufficient, understaffed and un-accessible due to lack of roads/transport indicating differential allocation of resources for rural areas
ABSTRACT
To determine the frequency of self-compliance to cervical screening guidance among the sexually active female gynecologists in tertiary care hospitals. To identify the possible barriers to effective screening in those who do not undergo cervical screening. Cross sectional study. This study was conducted in the obstetrics and Gynecology department of various tertiary care hospitals of Lahore from 1[st] Jun 2012 to 30[th] Nov 2012. Total 157 female gynecologists, serving in various positions in tertiary care hospitals of Lahore were interviewed by using a structured self reporting performa. The performa was designed to find out the number of gynecologists undergoing pap screening, and in those who fail to undergo screening the single most important barrier presumed to be preventing them from undergoing screening was also evaluated. In this study, only 3.1% of the subject population was found to be undergoing pap-screening, which reflects the national level of screening in urban areas,in sharp constrast to the studies being conducted in developed countries, with screening coverage rates of more than 80%. The prevalence of pap screening in the subject population is disappointingly low and drastic steps are needed to bring about a change in attitude of the subject population which cannot be brought about without changing the current culture of self-negligence and least prioritization for self, in the feminine part of our society
Subject(s)
Humans , Female , Mass Screening , Gynecology , Tertiary Care Centers , Cross-Sectional Studies , Papanicolaou Test , Surveys and QuestionnairesABSTRACT
To determine the knowledge and practice of myths associated with female reproductive life prevailing in our society. The study was taken in Gynaecology Department of Military Hospital Rawalpindi from 01st May 2008 to 30th May 2008. about 250 female patients attending the Gynae / Obst department of the Military Hospital as out patient were involved. Each patient was asked to fill up a Performa designed to assess knowledge and practice of myths associated with female reproductive life prevailing in our society. The participants ranged from various socio-economic and educational background; however majority of the patients reporting at the Gynae/ Obst department of Military Hospital Rawalpindi belong to lower socio-economic and poor educational background. Age was not selected as a criteria however only adult, married women were interviewed since these constitute the bulk of patients attending to the Gynae / Obst department of the Military Hospital Rawalpindi. A majority believed in myths related to menstruation, pregnancy, epidural analgesia, infertility and menopause. However the knowledge about family planning and C-section was quite up to date and majority did not believe in the myths related to these aspects of female reproductive life. The study shows that although the myths related to family planning and C-section are not affecting the life styles of majority of our population, but still there are areas in the female reproductive life like menstruation, pregnancy, epidermal analgesia infertility and menopause where concepts are not very clear in the general population and there is a need for proper health education of the masses regarding these aspects
Subject(s)
Humans , Female , Mythology , Health Knowledge, Attitudes, Practice , Pregnancy , Prospective Studies , Cesarean Section , Health Education , Reproductive MedicineABSTRACT
The objectives of this study were to determine the frequency of morbid adherence of placenta, its management outcome and complications in obstetrical patients admitted in Combined Military Hospital Quetta. Non randomized descriptive study. This study was conducted in the Labour and maternity wards of Combined Military Hospital Quetta. The duration of study was 01 year from July 2006 to July 2007. A series of 100 patients [emergency as well as booked cases] fulfilling the inclusion criteria were studied. Factors were studied in these cases included maternal age, parity, clinical presentation, gestational age, previous surgical procedures, ultrasound findings, type of morbidly adherent placenta, mode of removal of placenta, PPH, types of treatments offered, blood transfusions required, maternal morbidity and mortality, duration of hospital stay and condition of the patient at the time of discharge. Our results showed that only 04 patients out of 100 selected cases had morbidly adherent placenta, out of which 03 were booked cases and 01 was unbooked. These 04 cases were between 27years to 35 years of age. Their parity ranged from 2 to 4. Risk factors were found only in 03 patients. Placenta was found in lower uterine segment in 03 patients while in 01 case it was in upper segment. 01 patient presented with pre-term labour, 01 with antepartum haemorrhage, while PPH occurred in 03 patients. 01 patient delivered vaginally and 3 had caesarean sections. Two of these were placenta accreta, 01 placenta increta and 01 case had placenta percreta. Placenta was removed piece meal followed by caesarean hysterectomy in 03 cases and 01 was given a conservative trial followed by post-partum hysterectomy. Blood transfusions were required in all the cases ranging form 3-5 units. Complication of PPH occurred in 3 cases, uterine perforation in one case while DVT developed in one case. Hospital stay ranged from 7-14 days. Maternal mortality was nil in our study. Morbid adherence of placenta is an obstetrical emergency, which carries an increased risk of perinatal and maternal mortality and morbidity. Antenatal care should be improved and morbid adherence of placenta should be prediagnosed. The study showed a strong association of placenta accreta with previous caesarean section and placenta praevia
Subject(s)
Humans , Female , Pregnancy Complications , Pregnancy , Obstetric Labor Complications , Placenta Accreta , Placenta Previa , Hysterectomy , Disease Management , Hysterectomy , Cesarean SectionABSTRACT
To evaluate the etiopathological factors in infertile patients, detectable on endometrial biopsy. A total number of 100 endometrial biopsies were studied which were obtained from the patients undergoing investigations for infertility over a period of two years from Jan 2003 - Dec 2004, at Histopathology department Combined Military Hospital Sialkot, to find out the cause of infertility in these cases. All these patients were in fertile age group and were between 25 - 35 years of age. All of these biopsies were taken in premenstrual phase. The most common finding was late secretory endometrium [40%] which was consistent with the phase at which the biopsy was taken. Proliferative endometrium indicating anovulatory cycles was noted in 25% cases. Among the pathological findings, the most common was chronic non specific endometritis [15%] followed by endometrial hyperplasia [8%], chronic granulomatous endometritis of tuberculous etiology [5%] and endometrial polyp [3%]. 4% of the biopsies showed mid secretory endometrium which was also out of phase for the time at which biopsy was taken. Although endometrial biopsy is not the only diagnostic tool in women having infertility, however the confirmation of hormonal changes consistent with ovulation can be very helpful in management of these patients. The presence of out of phase endometrium and other endometrial patterns may direct the physician toward appropriate therapy. In addition, the therapy can be directed according to a specific etiology, if detected
Subject(s)
Humans , Female , Endometrium/pathology , Biopsy , Prospective StudiesABSTRACT
With the advent of ART [assisted reproduction techniques] the face of fertility for humans has changed. Couples previously unable to have children of their own now have a practical option to aid in pursuit of their fertility. With growing numbers of IVF [in vitro fertilization] and ICSI [intra cytoplasmic sperm injection] pregnancies, concerns regarding normality of these babies along with apprehension about their long term health are also mounting. This study was conducted to assess the growth and development of babies conceived by ICSI at the time of birth at the age of one month and subsequently at twelve months. To assess growth and developmental outcome of ICSI babies up to one year in comparison with babies born by spontaneous conception. A prospective cohort study. Twenty eight ICSI babies. All patients who underwent ICSI with a successful outcome from 15-10-2001 till 31-12-2004 were included. The outcome of pregnancy and gestational age were noted. The resulting neonates were evaluated critically at birth, 4 weeks and one year with regard to growth and development. The results were compared with age-matched controls and conclusions drawn. Growth parameters: weight, length and head circumference. Comparison of weight, length and head circumference between the observed mean and the mean of normal population at various ages for both boys and girls separately revealed that most of the babies had weight, length and head circumference within normal ranges. After correction for gestational age, all the pre-term babies caught up growth within the first year of life. ICSI babies do not have an adverse outcome with regards to their growth. However long term follow up is necessary to properly assess the developmental outcome. This needs to be confirmed by multicenter studies
Subject(s)
Humans , Male , Female , Fertilization in Vitro , Growth , Child Development , Prospective Studies , Cohort StudiesABSTRACT
To investigate the efficacy of auditory brainstem response [ABR] for hearing evaluation in children with conductive hearing loss. A prospective study from January 2006 to December 2006. Department of Paediatric Audiology The Children Hospital and The Institute of Child Health Lahore. Auditory brainstem response was carried out in 113 children with conductive hearing loss, in the age range of 25 days to 13 years, using A "EMG 14 multi- sensory evoked potentional system while sedating them with chloral hydrate and latency " intensity relationship was recorded for analysis. The patients with sensorineural and mixed hearing losses were excluded. Then, tympanometry with GSI " 38 Auto Tymp was done to evaluate middle ear functions. A total of 5777 children visited the hospital, out of which ABR was done in 911 [15.78%]. Among these, 113 [12.40%] children were with conductive hearing loss. 65 [57.52%] were males and 48 [42.48%] were females. 49 [43.36%] patients had mild bilateral conductive hearing loss and 10 [8.85%] had mild unilateral conductive hearing loss whereas 47 [41.59%] had moderate bilateral conductive hearing loss and 7 [6.20%] had moderate unilateral conductive hearing loss. 85 [75.22%] patients had D type, 20 [17.70%] had A type and 8 [7.08%] had E type tympanograms. Among these 113 patients, 77 [68.14%] were with OME, 28 [24.78%] with Down's Syndrome and 8 [7.08%] with perforation [either bilateral or unilateral]. It is concluded that auditory brainstem response can be reliably used in the detection of conductive hearing impairment and is an efficient method for threshold estimation in children
Subject(s)
Humans , Male , Female , Hearing Loss, Conductive/diagnosis , Hearing Loss , Auditory Threshold , Child , Prospective StudiesABSTRACT
Objective: To assess the prescribing patterns and clinical practices in the use of pharmaceutical agents in pregnancy
Study Design: Observational, Cross-sectional study
Study Period: March 2002 to March 2003
Setting: Study was conducted at antenatal clinic, Jinnah Hospital, Lahore
Materials and Methods: 250 patients from antenatal clinic were interviewed to collect information regarding age, parity, gestational age, any medication, its indication, route, duration and prescriber during current pregnancy on a pre-designed proforma
Sampling Method: Patients were enrolled in this study on first come and enroll basis
Results: Most of the women [90%] visiting the antenatal clinic were in the age group 21-30years. 94% of the women were taking medications and the prescriptions included haematenics [88%], folic acid [61%], calcium supplements [63%], antibiotics [22%], anti-fungals [19%], antiemetics [8%] and laxatives [6%]. 6% of women were not taking any medication. Commonest prescribers were general practitioners [46%]. Rest of the prescribers were medical officers at antenatal clinic [28%], LHVs/nurses [11%] and specialists [9%]. Self-medication was seen in 6%. 47% of the women taking self-medications were among the educated group [Matric and above] and 53% of the women were among the uneducated group [P < 0.001]. 28% took treatment from general practitioners and lady health visitors without any certain diagnosis, on symptomatic grounds
Conclusion: The use of drugs in pregnancy is substantial and varied. Information on the use of drugs during pregnancy is scarce and anecdotal. Careful consideration of the benefits to the mother and risks to the fetus is required, when prescribing drugs during pregnancy. All prescriptions or drugs recommended in pregnancy must have solid evidence derived from current literature