Prevalence of iron deficiency anemia during pregnancy in tertiary care hospital of Lahore

Objective: The objective of this study was to determine prevalence of iron deficiency anemia during pregnancy in tertiary care hospital of Lahore

Study Design: Cross sectional study

Place and Duration of Study: This study was conducted at the Department of Obs and Gynae, Lady Aitcheson Hospital Lahoreand was completed in 6 months

Materials and Methods: Data was collected using random sampling from 985 females in their last trimester. All pregnant females aged 1 6-40 years during their 3[rd] trimester were taken whereas the pregnant women with known history of thalassemia and sickle cell anemia were excluded from the study. Their demographic information regarding age, gestational age and parity was taken on predesigned Proforma. Venous blood sample was obtained and sent to hospital laboratory for analysis of their hemoglobin [Hb] level. All data was collected by principle investigator

Results: In this study the mean age of all pregnant females was 26.42 +/- 4.55 years with age range of 24 years [16 -40 years]

The average Hb level during third trimester was 9.18 +/- 0.98 with minimum Hb recorded as 4 and maximum Hb as 12. According to WHO classification 93.8% females were anemic and rest of 6.2% females were non-anemic but their Hb was not more than 12 mg/dL. On further classification it was found that 761 [77.3%] had moderate anemia, 157 [15.9%] had mild anemia, and 6 [0.6] were severe anemic. We found insignificant negative correlation of Hb with maternal age [r= -0.009, p-value = 0.767] and found significant positive correlation with number of antenatal visits [ r= 0.090, p-value = 0.005]

Conclusion: Moderate to severe anemia was highly prevalent in our study that may have serious feto-maternal outcomes

Further studies are suggested to address the problem of anemia and its associated causal factors

study of correlation of child birth weight with maternal body mass index

Objective: The objective of this study was to determine correlation of child birth weight with maternal body mass index [BMI]

Study Design: Cross sectional study

Place and Duration of Study: This study was conducted at Department of Obstretics and Gynaecology Lady Aitchison Hospital Lahore and was completed in 14 months

Materials and Methods: Data was collected using random sampling from 1000 females during post partum period. All pregnant females aged 18-35 years were taken and babies with intra uterine growth retardation [IUGR] were excluded.Data was managed in SPSS and was analyzed using same software

Results: In this study, the average maternal weight, height and BMI were 63.50 +/- 9.47 Kg, 154.10 +/- 4.85 cm and26.77 +/- 4.03 respectively.The mean babies' weight on delivery was 2.83 +/- 0.583 kg.There was significantpositive correlation of fetal weight with maternal weight [r=0.072, p-value = 0.024] and maternal BMI [r=0.086, p-value = 0.007].This correlation was stronger in females who had normal vaginaldelivery

Conclusion: Birth weight has a significantly positive correlation with maternal weight and BMI. Being modifiable risk factors, controlling these may considerable reduce the risk of low birth weight and associated complications for both mother and newborn

Tonsillectomy under local anesthesia: is it safe, feasible and practicable?

Background: Tonsillectomy is one of the most common ENT surgeries

Objective: The study was done to evaluate the feasibility of tonsillectomy under local anesthesia

Subjects and Methods: A total number of 80 consecutive patients whose tonsillectomy was performed under local anesthesia with systemic analgesic injections were included in this cross- sectional study. Peroperative difficulties and problems were noted. Similarly in post-operative period, the rate of complications was noted to conclude upon the feasibility of tonsillectomy under local anaesthesia

Results: A total of 80 patients were included in this study, with 36 females. Following complications were noted, Trismus [5%], difficult dissection [10%], primary hemorrhage [3.7%], reactionary hemorrhage [2.5%] and throat pain [10%]

Conclusion: We concluded that the procedure is safe, feasible and practicable but should be done with certain precautionsi

Work-family conflict and burnout among lecturers of public sector colleges

The aim of the current study was to investigate the relationship between work-family conflict and burnout among the lecturers of Govt. Colleges. Work-family Conflict Scale [Carlson, Kacmar, and Williams, 2000] and Maslach Burnout Inventory [Maslach and Jackson, 1986] were administered on the present sample. A purposive sample of lecturers [N = 200] including male [n = 100] and female [n = 100] was selected from different colleges of Faisalabad Division. Age range of the sample was 26-60 years [M = 41.20]. Pearson correlation was applied to study the relationship among study variables. The findings of the study indicate that Work-family conflict has significant positive correlation with emotional exhaustion, depersonalization, personal accomplishment, and burnout. Time-based conflict, strain-based conflict, and behavior-based conflict exhibited significant positive correlation with emotional exhaustion, depersonalization of' others, reduced personal accomplishment, and overall burnout. Finally, practical implications are discussed

Juvenile nasopharyngeal angiofibroma, experience of 35 cases with different surgical approaches

1] To study the clinical presentation. 2] To study the outcome regarding recurrence, prognosis and complications of different surgical approaches ofjuvenile nasopharyngeal angiofibroma. Observational study. The study was conducted at department of Ear, Nose, Throat. Head and Neck Surgery, Quaid-e-Azam Medical College and Bahawal Victoria Hospital Bahawal Pur, from March 2005 to February 2009. All young male patients presenting in ENT OPD/COD with complaint of recurrent nose bleeding, nasal obstruction and nasopharyngeal mass were admitted in ward. Detailed history was taken and thorough clinical examination done. Routine investigations and CT scan done in all cases. Staging done according to Fisch staging systems. Sufficient quantity of blood arranged and patient prepared for surgery. Specimen removed was sent for histopathological examination to confirm clinical diagnosis. Follow up was done for 12-18 months to see the recurrence and complications. Total 35 young male patients clinically diagnosed as JNA and postoperatively confirmed by histopathology were included in the study. Age range was between 10-25 years, majority were between 12-20 years [n-31]. All patients were male. All patients presented with epistaxis, nasal obstruction and nasopharyngeal mass. Other presenting symptoms were, anemia [n-29], nasal mass [n-27], ear blockage [n-27], nasal discharge [n-25], headache [n-22], snoring [n-15], speech defect [n-11] and proptosis [n-6]. All patients under went surgery. Seventeen patients were approached through lateral rhinotomy, 12 through transpalatal approach and 06 through Weber Furguson approach. In 05 patients recurrence occurred and in 11 patients postoperative complications occurred. Meticulous surgical approach depending on the stage of .TNA reduces the risk of recurrence and complications

Superficial cervical swelling in children; role of fnac in diagnosis - experience at Bahawalpur

Fine needle aspiration cytology [FNAC] is commonly used first line diagnostic test for palpable cervical swelling by ENT and Head and Neck surgeon. To analyze the diagnostic importance of FNAC by knowing its sensitivity and specificity in children having palpable cervical swelling. Prospective study. Department of ENT and Head Neck Surgery QAMC, Bahawalpur. July 2006 to June 2007. 82 cases of superficial cervical swelling with ages between 5 and 12 years were selected. Most of them were of poor socioeconomic class. All underwent FNAC for diagnosis and results were analyzed after comparing with histopathology examinations. Out of 432 total patients [of all ages] who attended the ENT department during the study period, only 82 were selected for the research which fulfilled the inclusion criteria. These were 5-12 years old, both sexes, 47 boys [57.3%] and 35 girls [42.75%]. Sixty eight [83%] patients had benign diseases while 14 patients [17%] had malignant lesions. Out of the 68 benign lesion [44.11%] were reaction hyperplasia [non specific inflammation], followed by tuberculous lymphadenitis [38.23%], cystic masses [5.88%], benign tumours [4.4%] and nodular goiter [7.35%]. Out of 14 malignant lesions, 6 [42.85%] had Hodgkin's Lymphoma, 2 [14.28%] had Non Hodgkin's Lymphoma, 3 [21.42%] patients had squamous cell carcinoma and 1 [7.14%] patient each of rhabdomyosarcoma, undifferentiated carcinoma and pleomorphic adenoma. In our study sensitivity and specificity of FNAC to diagnose the malignant lesion was 85.7% and 89.7% respectively. Accuracy of FNAC in our study was 89.0%. FNAC is highly helpful to diagnose the pathology of cervical swelling in children. It has high rate of sensitivity, specificity and accuracy to diagnose the malignancy in these lesions. Proper and specific sampling needs complete cooperation of the child and sedation may be necessary for this. Expertise is required for FNAC reporting

Some observations on the adaptation of Eimeria tenella (local isolates) sporozoites on chicken embryos through chorioallantoic membrane

Eimeria (E.) tenella (local isolate) sporozoites were adapted on the chorioallantoic membrane (CAM) of 10-12 days chicken embryos and completed its life cycle in 6~7 days at 39 degrees C and 70 per cent humidity. Only 23 embryos (4.6%) were found dead from 1~4 day post inoculation of sporozoites with mild lesions on CAM with no gametocytes but few sporozoites in chorioallantoic fluid (CAF). On 5~7 day post inoculation, 432 embryos (86.4%) were found dead with severe haemorrhages on CAM and CAF contained uncountable number of gametocytes. After seven days post inoculation, 45 embryos (9%) were found to be alive. Some oocysts were also detected in the CAF on 6~7 days post inoculation. In the histological sections of the CAM, there were abundant small dark colored rounded bodies of gametes; distributed extensively in tissues of CAM on 5~7 days post inoculation of sporozoites. In some cases, cluster of small mature and immature relatively large bodies were seen in increasing numbers on 5~6 days post inoculation.

Management of oesophageal foreign bodies

To evaluate management of oesophageal foreign bodies. Cross sectional analytic study. Department of otorhinolaryngology and head and neck surgery Bahawal Victoria Hospital Bahawalpur, from May 2003 to December 2004. A total of 186 patients with history of foreign body ingestion were admitted and included in the study. A structured questionnaire was designed to record the informations. X-ray neck and rigid oesophagoscopy was carried out to diagnose and remove foreign bodies. Out of 186 patients, 155[83.33%] were from paediatric age group and 31[16.66%] above 12 years of age. Coin was the commonest foreign body [77.41%]. Dysphagia was the commonest symptom [96.77%]. X-rays were conclusive in 181[97.3%] patients. Rigid oesophagoscopy was carried out in all cases and removal of foreign body was successful in 95.69% cases, and complication rate was very low

Management of bradyarrhythmias

BRADYCARDIAS, defined as a heart rate less than 60 beats/min are encountered frequently in clinical practice. The two main categories of bradycardia are related to dysfunction of the sinus node and atrioventricular [AV] conduction. The usual symptoms of bradycardia include dizziness, lightheadedness, fatigue, worsening of congestive failure, near syncope, and syncope. However, rates below 60 beats/min are not uncommon in asymptomatic individuals. Therefore, when patients experience the above-described symptoms and bradycardia is documented, it is crucial to prove that the bradycardia is the underlying cause. Otherwise, treatment of the bradycardia may not relieve patients symptoms. It is also not uncommon to see patients with symptoms of bradycardia who have no documentation of sinus node dysfunction [SND] or AV block. In these settings, therefore, further work-up is often necessary to reveal the underlying etiology for observed symptoms. The purpose of this communication is to discuss the approach towards the diagnosis and management of bradycardia in these clinical settings