Hepatitis B leading to megaloblastic anemia and catastrophic peripheral thrombocytopenia

Hepatitis B virus [HBV] typically causes chronic hepatitis, cirrhosis, and hepatocellular carcinoma. It is associated with a variety of extrahepatic complications. We herein, present a rare extrahepatic complication of HBV infection. A 32-year man presented with melena, bleeding from gums and fever. Peripheral blood examination revealed anemia, macrocytosis and severe thrombocytopenia. His hepatitis B surface antigen [HBsAg] was positive but deoxyribonucleic acid [HBV DNA] by polymerase chain reaction [PCR] was negative. Other hepatitis, human immune deficiency virus [HIV], dengue, and autoimmune serology were negative. Bone marrow examination revealed megaloblastic erythropoiesis. There was mild to moderate reduction of megakaryocytes in bone marrow, which was not compatible with severe peripheral thrombocytopenia. His response to cyanocobalamin and folic acid was remarkable for myeloid cell lines and moderate for erythroid cell lines, but poor to platelet counts. Platelet counts gradually improved to safe limits with eltrombopag, likely reflecting autoimmune pathogenesis for thrombocytopenia. This case report highlights multiple targets of HBV infection with associated multiple pathogenetic mechanisms

Histopathological analysis of gastric mucosal biopsies in non ulcer dyspepsia

Objective: To find out the pattern of gastric mucosal histopathological findings in gastric biopsies of patients with non ulcer dyspepsia

Study Design: Prospective descriptive study

Place and Duration of Study: Histopathology department Combined Military Hospital [CMH] Kharian Pakistan from Jan to Dec 2015

Material and Methods: One hundred patients presenting at outpatient gastroenterology department with dyspepsia having no endoscopic lesion were included in the study. Two gastric mucosal biopsies from antrum and two from corpus were taken. The specimens were processed and examined histologically to see the changes

Results: Gastric biopsies of 100 patients including 65 males and 35 females presenting with non ulcer dyspepsia were studied. Most of the patients were between the age group of 31-50 years. Histological examination of gastric biopsies revealed 70% of patients having histological features of gastritis, while 30% having no significant histological finding. Chronic inflammation was seen in 70 cases [70%], activity in 15 cases [15%], glandular atrophy in 2 cases [2%] and intestinal metaplasia in 2 cases [2%]. H.Pylori were identified in 25 cases [25%] based on haematoxylin and eosin [H and E] staining and modified giemsa staining

Conclusion: Most the cases of non ulcer dyspepsia show histological evidence of gastritis, however a significant number of patients showed no gastric mucosal histological abnormality. A significantly low frequency of H. Pylori in gastric biopsies noted in non ulcer dyspepsia cases may be due to more frequent use of antibiotics and acid suppressant drugs used by general practitioners at some stage of disease

Histopathological outcome of pancytopenia cases on bone marrow trephine biopsy

Objective: To determine the histological outcome of pancytopenia cases on bone marrow trephine biopsy and to see the frequency of various causes of pancytopenia in our population

Study Design: Descriptive study

Place and Duration of Study: Pathology department, Combined Military Hospital [CMH], Kharian [Pakistan]. One year [Jan 2015-Dec 2015]

Material and Methods: Two hundred bone marrow trephine biopsies were done in one year [2015], out of which 40 were done for evaluation of pancytopenia. The criteria for diagnosis of pancytopenia were; haemoglobin less than 10 g/dl, total leukocyte count [TLC] less than 4.0 x 109/1 and platelet count less than 100,000 x 109/1. Patients with pancytopenia secondary to drugs, chemotherapy and radiotherapy were excluded from the study

Trephine biopsies showing marked crushing and having inadequate material were also excluded from the study. Biopsies were processed, slides made and examined under light microscope by haematologist and histopathologist. Frequencies of various causes of pancytopenia diagnosed on histopathology were calculated. The findings were analyzed by using SPSS version 10.0

Result: Out of 40 cases of pancytopenia, male to female ratio was 3:2. The age range was between 1 year to 75 years. Histopathological analysis of bone marrow trephine biopsies revealed megaloblastic anaemia as the most common cause of pancytopenia [30%], followed by aplastic anaemia [25%] and hypersplenism [15%]

Conclusion: Megaloblastic anaemia is the most common cause of pancytopenia in our population as compared to aplastic anaemia mentioned in most of the international studies. This indicates prevalence of nutritional deficiency in our population and megaloblastic anaemia must be kept at top of list while evaluating pancytopenia cases. Early diagnosis and treatment of megaloblastic anaemia will prevent any further complication of this disease

Osteopoikilosis; a rare incidental spotted bone disease on CT

Osteopoikilosis is a benign, asymptomatic, sclerosing bone dysplasia with an autosomal dominant trait. The disease is characterized by diffuse symmetrical small round and ovoid radiopacities in the juxta-particular region of cancellous bone. We reported a rare case of a middle aged female presented with abdominal distension, whose radiological work up revealed an incidental osteopoikilosis

Frequency of ABO, and Rh [D] blood groups at Hyderabad, Sind and its territory

To see the frequency of ABO, subgroup ABO and Rh[D] blood groups in Patients, and donors, who attended the Liaquat university hospital for any type of surgery, Gynaecology and Obstratical problem, etc, of Hyderabad and its territory. Cross- sectional study. Department of Pathology and Diagnostic and Research Laboratory, LUMHS, Jamshoro/ Hyderabad, from February, 2012 to March, 2012. Donors and patients of both sexes, blood samples were collected under aseptic condition from anti-cubital vein for determination of blood groups. Subjects belonging to Hyderabad and its Territory, were included in this study. ABO blood grouping was determined by tile method using commercially prepared anti sera, anti A, anti B, anti AB [Plasmatic Kent, UK]. Presence of Rh D antigen was determined by anti-D [Biotic Laboratories Ltd UK]. For Rh-negative Du test was done. Our study shows, A positive-22.88%, A negative-02.31%, B positive-33.85%, B negative -03.27%, AB positive-08.27%, AB negative-0.77%, O positive-26.73%, O negative -01.92%. Regarding the management of blood bank and transfusion services in this area. ABO and Rh antigenic structure differs between regions and nations. Knowledge of blood group distribution may also play an important role for clinical studies, reliable geographical information and for forensic studies in the populations. Such studies need to be carried out at all the regional levels of Pakistan

Evaluation of patterns of beta thalassaemia in children with microcytic hypochronmic anemia

The aim of this study was to evaluate the patterns of Beta Thalassaemia in children suffered with microcytic hypochromic anemia in the different hospital of Hyderabad region. Cross-sectional study. This is an experimental based research study that was conducted at Isra University Hospital, Hyderabad and Liaquat University of Medical and Health Sciences Hospital Jamshoro Hyderabad from June 2011 to February 2012. Hundred [100] children from either gender attending outpatient department of Isra University Hospital and Liaquat University Hospital Hyderabad were selected for this study. Whole blood sample [10ml] was collected from each children. Peripheral smears were made and found that all children have suffered with findings of microcytic hypchromic anemia. Children with other than microcytic hypochromic anemia were excluded from this study. All parents of children were interviewed regarding family history and marriages with cousin and other findings or histories were also recorded on a well designed performa. Whole blood samples were analyzed for the evaluation of the patterns of Beta Thalassaemia in 100 children who were affected with microcytic hypochromic anemia. Out of 100 children, 08 of them were diagnosed as having beta thalassaemia minor, one as Beta Thalassaemia major and the remaining 91 were non thalassaemics. Among 08 Beta Thalassaemic minor children, 05 were females and 03 were males and only one male child was suffered with beta thalassaemia major. It is concluded that the prevalence level of beta thalassaemia is higher in Hyderabad, which is an alarming. Many factors such as poor facilities for diagnosis, lack of awareness among clinicians, consultants and pathologists and high cost of molecular diagnosis play a contributory role in the propagation of the beta thalassaemia in the Pakistani population. These factors become a serious hindrance for the prevention of thalassaemic program in Pakistan

Early assessment of outcome by ST segment elevation after acute myocardial infarction

Early assessment of outcome by ST segment elevation after acute myocardial infarction. Observational study. This study was conducted at Shaheena Jamil Teaching Hospital Abbotabad and Islam Teaching Hospital Sialkot from 1[st] January 2012 to 30[th] April 2013. 160 cases of acute myocardial infarction were randomly selected from the patients attending to OPD and emergency of Shaheena Jamil Teaching Hospital Abbotabad and Islam Teaching Hospital Sialkot and their peripheral Districts. During the study period, 160 patients met the criteria for inclusion and were given thrombolytic therapy. Out of these, 136 [85%] patients were males and 24 [15%] patients were females. Mean age at the time of presentation was 51.0 tears. 91 [56.8] patients had acute anterior myocardial infarction, 58 [36.2%] had acute inferior myocardial infarction and 11 [6.8%] patients had miscellaneous findings. Average time lapse was 4.03 hours from onset of the chest pain to administration of streptokinase. Group A' [complete ST segment resolution] included 67 [41.8%] patients while there were 49 [30.6%] patients in group 'B' [partial ST segment resolution] and 44 [27.5%] patients on group 'C' [no ST segment resolution]. The ST segment was raised in all of the acute myocardial infarction cases. But ST segment was resolved in patients in which streptokinase injection was given 4 to 5 hours back

Frequency of hepatitis a in patients with acute hepatitis in abbottabad

To investigate the frequency of hepatitis [A] in patients with acute hepatitis. Retrospective study. This study was carried out at Shahina Jamil Teaching Hospital Abbottabad from March 2006 to February 2008. The study included all acute hepatitis patients who visited the ShahinaJamil Hospital Abbottabad. Various viral markers were used to establish the diagnosis of acute hepatitis that included anti HAV IgM, HBsAg, anti HCV and anti HEV IgM. Liver function tests were also done. A total of 125 patients with acute hepatitis visited the out patient department of S.J. Hospital Abbottabad during the study period. The specific etiologic diagnosis could be made in 88 [70.4%] patients. Hepatitis [A] was found in 33[26.4%], HBV in 19[15.2%], HCV in 6[4.8%], and HEV in 30[24.0% patients. The mean age of the patients with HAV infection was significantly younger than patients with HBV,HCV and HEV. The present study showed that hepatitis A is one of the common type of viral hepatitis and can be controlled easily with improving sanitation and water distribution and personal hygiene

Malaria; assessment of haematological changes

To see the effects of malaria infection on platelet count and haemoglobin in children suffering from malaria. Descriptive study. CMH Okara and CMH Pano Aqil Cantt. July 2008 to June 2012. Children admitted with fever of less than seven days duration who had positive smear for malaria parasite were included in the study. After detailed history and thorough examination, patients were investigated to find out the cause of fever. All the patients with localizing cause for fever and history of drug intake were excluded. All patients were investigated with complete blood counts and serial peripheral smears for malaria parasite. Peripheral blood smear examination for malarial parasite was taken as gold standard for the diagnosis of malaria. Cut off 9 value for low hemoglobin [anemia] was taken as 10gm/dl and platelet count of less than 150x10[9]/L, was used to define thrombocytopenia. Patients with thrombocytopenia were divided in to three categories. Mild thrombocytopenia was defined as patients with platelet count of <50x10[9]/L to >150x10[9]/L, moderate thrombocytopenia included patients with platelet counts of <20x10[9]/L to >50x10[9]/L and severe thrombocytopenia consisted of patients with platelet counts of <20x10[9]/L. A total of one hundred and fourteen smear positive patients were analyzed, out of which 93% had low and 7% had normal platelet count. 95% had Vivax and only 5% had Falciparum malaria. Mean platelet count was 87x10[9]/L. Mean platelet count in Falciparum was 42x10[9]/L whereas it was 88 x10[9]/L in Vivax malaria. Sixty two [54%] patients had anaemia. Mean haemoglobin was 9.54gm/dl. Mean Hb in Falciparum malaria was 7.5gm/dl and in Vivax it was 9.6gm/dl. Higher frequency of mild to moderate thrombocytopenia and anaemia was observed in hospitalized children suffering from malaria. Plasmodium Vivax was found to be the most common species

Estrogen and progesterone receptor status and Her-2/Neu over expression in breast carcinoma with relation to age

Carcinoma of the breast is the common malignancy in Pakistani females. The study was conducted to assess estrogen receptor [ER], progesterone receptor [PR] and Her-2/neu over-expression in females with relation to age. Institution based prospective study. This study was carried out at the Histopathology section in the Department of Pathology, LUMHS, Jamshoro from March 2010 to December 2011. Fifty cases of breast carcinoma were selected to evaluate ER, PR and Her-2/neu over-expression by Immunohistochemistry [IHC]. The predominant histologic morphology was Infiltrating duct cell carcinoma. Majority of the cases presented with grade-II [78.7%] with a mean age of 46.5 years. IHC performed on 50 cases revealed ER +ve in 34 [68%] cases with a mean age of 47.5 years and ER -ve in 16 [32%] cases with a mean age of 44.5 years while PR +ve in 30 [60%] cases with mean age of 44.1 years and PR -ve in 20 [40%] cases with a mean age of 50.1 years. Her-2/neu over-expression was found in 15 [30%] cases with a mean age of 41.6 years and Her-2/neu -ve in 35 [70%] cases with a mean age of 48.6 years. ER and PR expression was found at a significant level reflecting a good therapeutic and prognostic value but the frequency of Her-2/neu over-expression was high reflecting a bad prognosis

Effectiveness and feasibility of transabdominal chorionic villous sampling procedure for prenatal diagnosis of beta-thalassaemia in a Muslim majority community of Pakistan

To determine the effectiveness and feasibility of transabdominal chorionic villi sample [CVS] procedure for prenatal diagnosis of beta-thalassaemia in a Muslim majority community. Between January 2005 and December 2011, we analysed 798 high-risk mothers with 12-16 weeks of pregnancy for beta-thalassaemia using CVS, performed with a transabdominal route under local anesthesia and ultrasound guidance. The chorionic villi extracted were investigated upon using genomic amplification of beta-globin gene by polymerase chain reaction [PCR]. A total of 798 of which 224[28%] fetus were diagnosed as major, 400[50.1%] as minor, 173[21.6%] as healthy fetus and 1[0.12%] fetus had undetected mutation. Procedure related complications were seen in 20 cases [2.4%] and missed abortion occurred in 6/798. Seven [3%] couples had refused to abort beta-thalassaemia major fetus where as 97% fetus was aborted as per recommendations. Ultrasound guided transabdominal CVS is an effective procedure for prenatal diagnosis of beta- thalassaemia in a Muslim community. We found no cultural hurdles for fetal sampling and prenatal diagnosis

Pulmonary tuberculosis; age related radiological findings

To study the age related radiological finding in pulmonary tuberculosis. Across sectional study. From January 2009 to December 2009 pulmonary department of Bahawal Victoria Hospital Bahawal Pur. The cases diagnosed as pulmonary tuberculosis of either gender above age of 12 years were included in the study. Patients suffering from extra pulmonary tuberculosis, treatment failure, relapse, drug resistant tuberculosis and HIV sero-positive patients were excluded from the study. Patients were divided into groups according to the age. Group 1 consist of patients having age >/= 50years while group 2 consist of patients having <50 years. Data was recorded on the Proforma and was analyzed statistically on SPSS 11. this study consists of 106 patients and divided into two groups. It has been found that apical zone of lung involvement was more common in patients younger than 50 years while involvement of lower zone was more common in patients with age >/= 50years. No significant difference was found regarding the involvement of middle zone, multiple zones and the type of lesions as the p-value was >0.05. The elderly patients with pulmonary tuberculosis have predominant involvement of lower zones. So, lower zone involvement of radiological lesions should be evaluated for pulmonary tuberculosis to start the treatment earlier and to minimize the risk of missing the diagnosis

Multi nodular goiter; frequency of malignancy and its histopathological types. a tertiary care hospital experience

I. To determine the frequency of malignancy in multi nodular goiter. II. To determine the histopathological types. This is a prospective study. Surgical department of Foundation Hospital Rawalpindi and associated Teaching Hospital of Frontier Medical College Abbottabad. Aug. 2002 to Aug. 2007. One hundred patients with Multi nodular were included in this study. Patient with diffuse goiter, solitary nodules, patient operated somewhere else and suspected cases of malignancy were excluded from the study. Tissue were sent to Armed Force Institute for histopathological examination. Patients were followed for 2 weeks after surgery with histopathological report, all the preoperative and postoperative findings were recorded in detail. Data was analyzed byusing SPSS 14. Majority of patients studied, belonged to Azad Kashmir and Gilgit which are among the known endemic regions for goitre in Pakistan and other from Chakwal and Jhelum. Histopathology revealed 96 [96%] patients with multi nodular goiter, 3 [3%] papillary carcinoma and 1 [1%] Follicular carcinoma. Multinodularity of the goitre should not be considered as low risk of malignancy and delay for surgical intervention. Changes in the size of gland, the appearance of new and hard nodules or cervical lymphadenopathy may indicate malignant change and prompt indication for surgery

comparison of arch dimensions among different malocclusion groups

The aim of this study was to compare the dimensions of dental arches among the three malocclusion groups and see the gender dimorphism in these dimensions. This was a cross sectional study conducted at dental clinics, the Aga Khan University Hospital, Karachi. A total of 110 patients belonging to different malocclusion groups were evaluated. Our inclusion criteria were 1] Presence of all permanent teeth from first Permanent molar to first permanent molar 2] No previous orthodontic treatment and 3] Age range of 13-30 years. All patients suffering from some developmental anomalies and/or syndromes were excluded. The mean maxillary intermolar, inter 1[st] premolar, inter 2[nd] premolar and intercanine widths and arch depth were 49.96mm, 40.13mm, 44.4mm, 34.02mm and 39.41mm respectively for the entire sample. The mean mandibular intercanine, inter 1[st] premolar, inter 2[nd] premolar and intermolar widths and arch depths were 26.90mm, 33.40mm, 38.72mm, 43.49mm and 33.72mm respectively for the whole group. Significant differences were found in maxillary inter-premolars and inter-molar widths among the three groups. A comparison between the two genders showed significant differences in mandibular intercanine and intermolar widths among the three groups. Significant differences were found in maxillary intermolar and interpremolar widths among the three malocclusion groups. Class Ill group had the largest maxillary intermolar and interpremolar widths followed by Class I group. Male subjects had significantly larger maxillary and mandibular intermolar widths and mandibular intercanine widths than females

Obesity, hyperlipidemia, and hyperuraecemia in young and old hypertensive patients

There is strong correlation among hypertension, obesity, hyperlipidemia and hyperuricemia which are important risk factor for the cardiovascular disease. Objective of this study was to assess and compare the prevalence of obesity, hyperlipidemia and hyperuricemia among young and old hypertensive patients in the local setting. This cross-sectional study was conducted at medical Out-patient Department at Shahina Jamil Teaching Hospital, Abbottabad, from September 2007 to February 2008. Eighty-six patients seen in the medical outpatient department were enrolled in the study. Patients with age 15 years or above and diagnosed as case of systemic hypertension were included. Patients with endocrine disease, pregnancy, coarctation of aorta, and renal disease leading to hypertension were excluded from the study. Total eighty-six patients with mean age of 53.7 +/- 12.9 years were included in the study. Patients were divided into younger age group [age <46 years] and older age group [age >/= 46 years]. Mean Body Mass Index [BMI] was 29.7 +/- 5.2 in the younger age group and 26.9 +/- 4.7 in the older age group, mean serum cholesterol level was 192.2 +/- 14.2 mg/dL in younger age group and 190.9 +/- 18.3 mg/dL in the older age group, mean serum triglyceride level was 170.5 +/- 13.7 mg/dL in younger age group and 166.6 +/- 21.4 mg/dL in the older age group and mean serum uric acid levels were 5.6 +/- 0.7 mg/dL in younger age group and 5.7 +/- 1.2 mg/dL in the older age group. Overweight and obese patients were 70.9% with its higher prevalence in younger [86.2%] as compared to older patients [63.2%]. Hypercholesterolemia was found in 27.9% of the patients, with a frequency of 24.1% in younger patients and 29.8% in the older patients. Hypertriglyceridemia was seen in 66.3% of the patients, with a frequency of 69.0% in younger patients and 64.9% in the older patients. Hyperuricemia was present in 37.2% of the hypertensive patients with a frequency of 34.5% in the younger patients and 38.6% in the older patients. Hypercholesterolemia, hypertriglyceridemia, and hyperuricemia are not associated with the age of the hypertensive patients. Increased BMI is more frequent in the young as compared to the old hypertensive patients

investigation of mechanism of vasodilator activity of 17 beta-estradiol as being geriomic or non-genomic

To determine the vasodilator activity of 17 beta-estradiol as being genomic or non-genomic. The experimental protocol was divided into three groups, In group I aorta of rat was subjected to serial dilutions of norepinephrine and a standard concentration was selected, which produced optimal vasoconstriction. In group II, tissue was challenged with serial dilutions of 17 beta-estradiol in the presence of vascconstriction induced by the standard concentration of norepinephrine. Meanwhile in group III tissue was challenged with serial dilutions of 17 beta-estradiol in presence of standard concentration of norepinephrine after pretreatment with dactinomycin, which was used to inhibit protein synthesis so that genomic mode of action could be blocked. In our study 17 beta-estradiol, after pretreatment with dactinomycin, produced vasodilator activity in the same pattern as obtained without administration of protein synthesis inhibitor in the tissue preconstricted with norepinephrine [P<0.001]. The observations demonstrate the vasodilator activity of the 17 beta-stradiol to be its non-genomic action

Evaluation of zinc status of preschool children as assessed by hair zinc level in Punjab province

To determine status of zinc in healthy children in some parts of Punjab province by estimation of hair zinc levels. Descriptive study [cross sectional survey] The study was organized at KRL Hospital from August 2004 to January 2005. Study samples were selected randomly from a larger study [To evaluate vitamin A status] carried out in 6 districts of Punjab. This community-based study was done in 6 districts of Punjab including Mianwali, Jhang, Attock, Multan, Pak Pattan and Faisalabad. The population selected was 1-5 yr old healthy children. Both male and female healthy children were included. Malnourished children with mid arm circumference <12 cm, children with skin and hair disorders, liver disease and prolonged illness were excluded from the study. After parental consent and filling up of questionnaire data, hair samples were collected. Relevant features like age, sex, dietary history and previous illnesses were recorded. Hair samples were taken, sealed in dry plastic bags and dispatched to Dr A Q Khan Research Laboratories [KRL] Kahuta where they were analyzed using atomic absorption spectrophotometery. Data analysis was performed through SPSS-10.0. Mean age of study population was 37.5 +/- 13.39 months and male to female ratio was 1:1.32. Hair zinc levels ranged from 69 to 227 micro gm/gm of hair. Mean hair zinc level was 164.79 +/- 53.7 micro gm/gm of hair. Majority of children [62] had an adequate zinc level, while 13 were identified with low zinc status [<100 micro gm/gm]. Hair zinc was not significantly higher in children with adequate dietary habits, similarly there was no association with age and gender. Majority of healthy pre-school children in the sampled districts of Punjab did not have zinc deficiency as assessed by hair zinc level. However about 1 in 10 children was deficient in zinc even in the healthy population

Fetomaternal outcome of pregnancy between 40 and 42 weeks

To evaluate whether serial monitoring of fetuses beyond 40 weeks with biophysical profile and non stress test improves the fetal outcome in terms of morbidity and mortality. Prospective control study. Department of Obstetrics and Gynaecology at Ittefaq Hospital[Trust] Lahore,. From Jan, 2007 to June 2008. Two hundred women with singleton uncomplicated pregnancies at 40 weeks were divided into two groups; A study group with biweekly biophysical profile and non stress test and a control group with biweekly antenatal clinical assessment with fetal kick count chart. Main outcome measures were onset of labour, mode of delivery, Apgar score, presence of meconium and admission to nursery. The age of patients ranged between 18 to 39 years with the mean of 26.33.The range of gravidity was between primigravida to gravida seven. Ninety six percent of total patients were delivered by 41 weeks and 6 days.18% of women were induced in study group compared to 11% in control group [p value=0.124].Cesarean section rate was 8% in study group and 11% in control group. Rate of instrumental deliveries was 6.5% in study group while 11.2% in control group. The difference in mode of delivery was found to be insignificant [p=0.538].Weights of the babies ranged between 2.6 to 4.4 kg with a mean of 3.246 kg. Cumulative%age of APGAR score at 5 minutes was more than 6/10 in 92.5% cases [p=0.665].Meconium was found in 18% of cases in study group and 22% of control group[p=0.917].12% of the babies were admitted to nursery in study group compared to 16% in control group. Perinatal mortality was found to be 10/1000 in control group while there was no perinatal death in study group. The difference of outcome between two groups was found to be statistically insignificant which concluded the validity of either mode of management

Assessment of socio-economic status of patients

To determine whether or not doctors assess the socio-economic status of their patients in order to customize treatment and improve compliance. A cross-sectional Jinnah Hospital and Shalimar Hospital Lahore. From March to June 2005 Ninety-three patients were included from each of the two randomly selected tertiary care hospitals [one public, one private] of Lahore. Doctor-patient encounters were observed. No assessment was made for 134/186[72%] patients. 51/186[27.4%] received an inadequate assessment. Only 01/186[0.5%] patient received a thorough assessment of his socioeconomic status. Doctors in the private hospital made better effort to assess the socioeconomic background of the patient [albeit inadequately], compared to those in the public hospital [p: < 0.0001]. Doctors should be regular and meticulous in patients' socioeconomic status assessment

Birth weight pattern of newborns in hospital setup

The objectives of the study were to determine the distribution of the birth weight of the newborns and identify the effects of gender, parity and socioeconomic status on it. CMH Thai [Kohat], KRL Hospital Kahuta and POFs Hospital Wah Cantt from Jun 2002 to Sep 2005. All the live born singleton normal babies born between 37-42 weeks of gestation were included. Premature babies, babies with congenital anomalies and those born to the mothers with malnutrition, obesity, anemia, chronic illnesses and obstetric complications were excluded from the study. Birth weight of each baby was measured to the nearest 100 gram on a baby weighing scale. Infants having birth weight of 2.5-4.0 kg were termed as normal birth weight, those less than 2.5 kg as low birth weight and more than 4.0 kg as large weight babies. Data was analyzed using SPSS v.10. The total number of babies was 1026. Males were 54% and females were 46%. Mean birth weight was 3.08 kg. Birth weight ranged from 1.6 kg to 5.0 kg. Mean birth weight of male babies and babies of higher socioeconomic group was higher than that of the females and the babies of lower socioeconomic group. Seventy nine percent of the neonates had a normal birth weight. Sixteen percent had low birth weight and only 5% were large babies. There was no significant difference in the mean birth weights of the babies of mothers with different parities. This study revealed that majority of analyzed population had normal birth weight. Male neonates and babies of higher socioeconomic group were heavier as compared to females and those of lower socioeconomic group. Parity however did not have any significant affect on the birth weight