A Rare Case Report on Benign Recurrent Intrahepatic Cholestasis.

Benign recurrent intrahepatic cholestasis is an inherited and occasionally sporadic disease presents as recurrent episodes of obstructive jaundice without any obstruction in billiary channel with intervening symptom free periods. Here we are presenting a case of 20-year-old male with a recurrent jaundice and pruritus who later diagnose as BRIC.

Level of hypercholesterolemia in patients admitted for heart diseases: a pilot study

Hypercholesterolemia in 388 indoor and outdoor patients of Ayub Hospital Complex was determined. The mean cholesterol level was 209 mg/dl. The male to female ratio was 2.6:1. There was no significant [p>0.05] difference in serum cholesterol level between males and females. The serum cholesterol of 149 [38.4%] patients was on borderline high [201-275 mg/dl]. Among these 39[26.17%] were females while 110[73.82%] were male patients. The results indicate that there was high rate of cholesterol levels in patients admitted for heart disease or those on high risk of confronting IHD

ARI in children: a case management intervention in Abbottabad

A community-based program of acute lower respiratory infection [ALRI] case management was conducted in a rural district of northern Pakistan. The impact on infant and child mortality of this program was evaluated. During 1985-1986, ALRI-speciflc mortality among children <5 years old living in 31 intervention villages was 6.3 deaths per 1000 children per year compared with 14.4 in seven control villages [p=0.0001]. Within one year after interventions were extended to the control villages in 1987, ALRI-specific mortality in these villages dropped by 55% to 6.5 per 1000 children per year [p=0.06]. Total child mortality in 1985-86 was 29.0 per 1000 children per year in the intervention villages and 39.4 in the control villages, a difference of 28% [p=0.01]. With interventions in 1987, total child mortality in the control villages declined by 29% to 27.8 per 1000 children per year[p=0.09]

Successful treatment of cutaneous leishmaniasis with intralesional glucantime

We performed a clinical trial to evaluate the efficacy and safety of intralesional glucantime in cutaneous leishmaniasis. Thirteen patients with cutaneous leishmaniasis were treated with intralesional glucantime using a 23 gauge needle. Each lesion was infiltrated with 1-2 ml of solution without local anaesthesia. Total number of injections was from 3 to 5, each one week apart. Resolution of the lesions was obtained in most of the patients [9 out of 13]. The location and duration of the lesion did affect the outcome of treatment. The treatment was generally well tolerated. Intralesional treatment of cutaneous leishmaniasis is safe, effective and cheap, and excellent cosmetics results may be achieved

Fluoride levels of drinking water and dental caries in Hazara and Mianwali

Two hundred and sixteen drinking water samples from various sources in Hazaza Division and District Mianwali were tested for fluoride levels. In Hazara Division, out of 161 water samples, only 4 samples were found to have fluoride levels within acceptable range [0.8-1.5 PPM], remaining samples had fluoride either very low or not at all. The fluoride range was from 0.0 to 0.9 ppm with a mean of 0.11 ppm. In District Mianwali, 55 drinking water samples were tested, the fluoride content was within normal limits or high, except few samples having less fluoride concentration. The range was 0.3 to 6. 5 ppm with mean of 1.46 ppm. 1739 Primary and High School going boys and girls of District Abbottabad, Haripur and Mianwali were examined for dental caries. In Hazara Division 61% were found to have mild to severe dental caries while in District Mianwali, it was only 4.9% while mottling was 14.6%

prospective study of risk factors analysis in patients with acute myocardial infarction

Coronary atherosclerosis is multifactorial in its aetiology. The Framingham Study has shown a clear correlation between certain identifiable risk factors and the subsequent development of cardiovascular events in predisposed individuals. A prospective study was carried out to document and analyse the presence of all the major risk factors in a population of patients with an acute myocardial infarction. One hundred and three patients were included in the study comprising of 84 males and 19 females with an average age of 57.6 years. Overall hypercholesterolemia was found in 42%, cigarette smoking in 52% of males, hypertension in 16% and hypertriglyceridemia in 31% of the patients. Obesity was present in 29%, diabetes mellitus in 13%, and a family history of Coronary Artery Disease [CAD] was detected on 10% of the patients studied. At least 82% of the patients had at least one identifiable risk factor. This confirms the significant presence of conventional risk factors in this prospectively studied population of patients with myocardial infarction

Protein electrophoretic pattern in healthy and pulmonary tuberculosis subjects

Serum protein electrophoresis of 30 healthy subjects [20 males and 10 females] and 30 pulmonary tuberculosis patients [16 males and 14 females], of different age groups, was carried out on cellulose acetate membrane. It was observed that in healthy subjects, the mean concentrations of total protein, albumin and beta-fraction of globulin were higher in males, while alpha-I and alpha-2 were higher in females. No significant difference was noted in the levels of total globulins and gamma globulin in both sexes. On the other hand, the pattern in pulmonary tuberculosis patients during active stage of the disease showed that the albumin content was decreased while the mean levels of total protein and all the globulin fractions were increased in both males and females. alpha-2 and Gamma globulin values were highly increased and a slight increase in the concentration of total protein and beta-globulin fraction was found

Study of foetal hemoglobin [HbF] and glucose-6-phosphate dehydrogenase [G6PD] in children of hilly areas of Abbottabad

Two hundred and thirty apparently healthy children [150 males and 80 females] and 120 refractory anaemic children [70 males and 50 females] of different age groups were investigated for Foetal Haemoglobin [HbF], HbA2 and Glucose-6-Phosphate Dehydrogenase [G6PD] for a period of 18 months. Age ranged between 8 months to 14 ears. The mean Hb of healthy and anaemic children was 13.9 g/dl and 6.4 g/dl respectively. The mean HbF levels were 0.917, in healthy and 13.6% in anaemic children. Twenty four percent of anaemic children had elevated HbF wind most of them showed associated increase of HbA2. Ten cases of thalassaemia major and 19 cases of thalassemia minor were identified. Among the healthy children, three males and one female were found to be CdFPD deficient, while in anaemic children, 8 males and 4 females had G6PD deficiency. No relationship was observed between HbF and G6PD. However, an unusual case was found who had inherited G6PD deficiency from father and beta thalassaemia from the mother's side

Serum total protein profile in children under 5 years age at women and children hospital, Abbottabad

A study of serum protein profile was done in 324 infants/children suffering from meningitis, pneumonia, enteric fever, diarrhoeal diseases, gastro - enteritis, malaria, septicaemia, rheumatic fever, cirrhosis, tetanus and leishmaniasis. Pneumonia and meningitis were the common diseases in the study. Hypoproteinaemia was found in only 4% of the patient of diarrhoeal diseases while hypoalbuminaemia occurred in all cases of septicaemia and cirrhosis. Alpha-I globulin was raised in 56% of meningitis, 60% cases of rheumatic fever, 20% of the enteritis fever and all of the septicaemia cases. It was markedly less in cirrhosis. Alpha-2 globulin was high in 85% of meningitis, 64% of pneumonia, 41% enteric fever, 38% of diarrhoeal diseases, 8% of gastro-enteritis and all of septicaemia, rheumatic fever and leishmaniasis. Beta globulin fraction was increased in rheumatic fever and cirrhosis only. Marked hypergammaglobulinaemia was found in septicaemia and cirrhosis. Hypogammaglobulinaemia was detected in 62 [19%] patients. Bisalbuminaemia, a genetic abnormality was seen in only one case. Alpha-2 globulin was raised in 7[8.5%] while Hypogammaglobulineemia was found in 4[4.9%]. Serum protein and its fraction determination is a valuable diagnostic aid for infections and some genetic abnormalities

Infant feeding practices in the rural and urban areas in district Abbottabad

This article summarises the findings of a field study of infant feeding patterns in Urban and Rural areas of District Abbottabad. The main purpose of this study was to find out the reasons of declining trend of breast feeding. Over 70% rural mothers had no education and about 93% did not go to school. Average duration of breast feeding was observed to be 5.8 months and 19.2 months in the urban and rural areas respectively. The degree of suckling in urban and rural women was 9.7% and 24.7% respectively. It was observed that in urban areas 96% infants received breast milk for first 4 months of their life and by 2 years this level was dropped to 31%. In rural areas mothers breast fed their babies for 2 years on the average. 57% rural mothers believed that breast feeding is natural thing to do. The most obvious reason for stopping breast feeding was the next pregnancy. Urban mothers preferred brand name cereals as compared to home made, which are most commonly used by rural mothers

G6PD deficiency and beta-thalassaemia in the same patient

A report of 8 months old female child with a rare combination is presented who had inherited G6PD deficiency from father and Beta-Thalassaemia from mother

Nutrition and acute respiratory infection[ARI]

Seven hundred and sixty children, under 5 years of age were followed up for two years and data collected indicate the following nutritional status. 22% have normal nutrition, 54% have mild malnutrition, 17% have moderate malnutrition and 7% have severe malnutrition. It was observed that significantly greater proportion of severely malnourished children had poor housing facility and did not receive childhood immunization. Thee incidence of ARI with normal and mild malnutrition was [6.46 per child per year. However, this incidence was essentially the same as that for children with moderately severe and severe malnutrition [6.56 per, child per year]. Thus, the results indicate that malnutrition did not correlate with increased overall incidence of ARI. The impact of malnutrition on hospitalised cases indicated that about half of these admitted cases had associated illnesses, mostly Diarrhoea or Measles. Case fatality rate [CFR] in normal children was essentially similar to that of children with mild malnutritions. CFR of children with severe malnutrition [7.54%] has been observed to be significantly higher than either normal or those with mild malnutrition

Serum protein and albumin, lipid and cholesterol concentration in normal adult population of district Abbottabad

Serum Protein and albumin, lipid and cholesterol levels were studied in 200 randomly selected apparently healthy subjects [118 males and 82 females] of different ages. Age range was between 20-70 years. No significant difference was observed in total protein and albumin levels in both sexes of various age groups. Lipid pattern was positively correlated with the age in males however, in females, this pattern was decreased after 50 years age. Cholesterol showed a progressive rise in both sexes between the ages 20-49 years after which begin to fall. Results also showed Lipid and Cholesterol levels were lower in the females compared to age matched males

Disorders of hemoglobin: a pilot study on hospital patients

During a period of three years, two hundred and sixty four patients with chronic anaemia were investigated for disorders of haemoglobin. Of these cases, 53% were children of less than 4 hears. The common clinical features included anaemia, abdominal distension, fever and hepatosplenomegaly. Fifty eight cases [22%] were identified as B-Thalassemia, of these 30 cases [52%] were homozygous and the remaining 28 cases [48%] heterozygous. Only one case [0.4%] of sickle cell trait was identified, 77.6% did not show any abnormality in Haemoglobin. The prevalence of various haemoglobinopadlies was also studied in a control group of 304 healthy subjects. Only four subjects [1.3%] had a moderate elevation of HbF, which was identified as hereditary persistence of foetal haemoglobin HPFH