Neck pain-a problem with major effects

To study the prevalence of neck pain in patients and their effects on daily performance. Hospital based observational study. OPD of Mayo Hospital and private chamber of the consultant. Neck pain as a cause of morbidity in both genders with loss of work hours leading to economic and household pressures. A total of 100 patients were studied. Out of these 54% were males and 46% were females. Age range was 15-70 years with the mean of 37 +/- 15.12 years. Duration of pain was from range 1-10 years with the mean of 4 +/- 3.80 years. Sixty nine percent were married and 31% were unmarried, 74% had urban and 26% had rural background. Out of these 69% were working in sitting posture and 31% in standing posture with bent necks on their jobs. Pain was radiating to arms in 53%, dull localized in 34%, stabbing in 9% and of burning character in 4% of patients. No neurological deficit was noted except that movements of neck were painful with associated muscle spasm. These patients were put on muscle relaxants, analgesics, advised extension exercises and told to improve their working conditions by keeping high desks or soft cervical collar. 78% patients showed improvement in the pain and radiation whereas 22% did not get any relief who were referred to physiotherapy department. Neck pain and associated neck muscle pain is a common symptom. The muscle spasm can be overcome by good posture, proper position of neck during work, avoiding very long hours of bent neck. NSAIDs, muscle relaxants and light extension along with exercises of neck can overcome such problems

Is there need of specialized diabetes nurses in Pakistan?

To assess the knowledge of the staff nurses of diabetes mellitus working in the various wards of a teaching hospital of Lahore. Cross-sectional study. Hospital based, on the staff nurses working in medical, surgical, cardiology, emergency and psychiatry wards of Mayo Hospital, Lahore. Main outcome measures: Knowledge of diabetes mellitus of staff nurses. Fifty qualified nurses interviewed through questionnaire designed to assess their knowledge about various aspects of diabetes. Symptoms of disease known to the nurses were polyuria [86%], polydipsia [82%], delayed wound healing [74%] unexplained ill health [72%], whereas pruritus vulvae [62%], big sized babies at birth [42%], impotency [40%] were elicited in response to prompting. Sixty% of them were unaware of gastrointestinal symptoms. They were better aware of hypertension [90%], chronic renal failure [70%], ischaemic heart disease [50%] as associated diseases with diabetes mellitus and least aware of autoimmune diseases. Confusion/drowsiness [92%], profuse sweating [80%], heart sinking [72%], blurring of vision [68%] fatigability [68%] pallor [52%], irritability [34%], lack of concentration [26%], feeling of hunger [20%] were known as hypoglycaemic symptoms. They generally had the knowledge of the treatment and was quite adequate. Diet control [92%], diet and exercise [96%], oral and parenteral hypoglycaemic agents [100%] were known to them. However they were less knowledgeable about alteration in treatment. Majority were of the opinion that patients should be controlled on oral hypoglycaemic agents and avoid parenteral drugs. Although nurses knew the diet plays the role in management of diabetes mellitus, but were not aware of types of food given to the patients or how to make changes in the diet. Nurses working in emergency, medical as well as surgical units should undergo refresher courses for 1-2 weeks in nursing care of diabetics. Effort should also be made to train specialized diabetic nurses. This would reduce the burden on doctors besides improving diabetic care

Patients with postpartum complications admitted in a medical ward of Mayo Hospital, Lahore

To evaluate the postpartum complications and their outcome in patients who were admitted between the periods of 1st July 1999 to 30th June 2000 in a medical ward following delivery. A prospective study of patients who were admitted in a medical ward with various postpartum complications following delivery at home or hospital. Department of Medicine, Mayo Hospital/K.E. Medical College, Lahore, Pakistan. Sixty-four patients who were admitted through emergency or referred/shifted from obstetrical wards attached to the hospital. Out of 64 patients, septicemia was detected in 26 [40.5%], renal failure in 8 [12%], Disseminated Intravascular Coagulation [DIC] in 6 [10%], jaundice in 6 [10%], eclampsia/fits in 8 [12%], tuberculosis in 4 [6%], tetanus in 3 [5%], postpartum cardiomyopathy in 2 [3%], stroke in 1 [1.5%]. Fifty-two [81.24%] were discharged home, 6 [9.38%] died in the hospital and 6 [9.38%] left against medical advice [L.A.M.A.] in moribund condition. Only serious postpartum complications present in medical wards. Physician, obstetrician and other specialties should act as one team to prevent maternal mortality and morbidity

Skin manifestations amongst diabetic patients admitted in a general medical ward for various other medical problems

To calculate prevalence of incidental skin manifestations in patients with diabetes mellitus admitted for treatment of various other medical problems in a general medical ward of a teaching hospital, Lahore, Pakistan. Design: Cross-sectional study. Setting: Hospital based study on admitted patients in a medical ward, Mayo Hospital, Lahore. Subjects: One hundred consecutive adult diabetic patients of any age and either sex admitted for various other diseases/problems. Main Outcome Measures: Skin manifestations. Out of 100 patients, 60% were males, and 40% females. Skin manifestations were seen in 90% of patients. Diabetic neuropathy was seen in 65.6%, cutaneous infections in 62.2%, pruritus in 46.7%, Diabetic dermopathy in 33.3%, skin tags in 21.1%, acanthosis nigricans in 16.7%, eruptive xanthomas in 8.9%, vitiligo in 6.7%, diabetic bullae in 5.6%, diabetic rubeosis in 5.6%, lichen planus in 4.4%, erysipelas like erythema in 4.4%, trophic ulcers in [3.3%], wet gangrene foot in 2.2% and necrobiosis lipodica, granuloma annulare and reacting perforating collagenosis in 1.1% each. Conclusions: There are many skin manifestations amongst diabetics who are also suffering from various other medical problems. Patients in routine do not give much importance to these lesions because they appear harmless to them. They do not seek advice of physician/surgeon/dermatologist unless they develop serious skin and soft tissue infections like carbuncles, trophic ulcers or gangrene