Comparative study between intranasal antrstomy and antral lavage an experience at CMCH Larkana

To compare the results of intranasal asntrostomy and antral lavage in maxillary sinusitis. This randomized control study was conducted in the department of ENT Chandka Medical College Hospital Larkana during the period from December 2004 to 2007. The overall study of 150 cases was conducted. Out of 150 cases 92 [61.31%] were male and 58 [38.71%] were female and the male / female ratio was 1.6:1. Symptomatology was dominated by PND 95% purulent rhinorrhea 70% headache 52% and nasal obstruction 25%. The overall result of 150 patients x-ray showing mucosal theckining 89 [59.3%] hazzy / opaque sinus 40 [26.6%] and fluid level 14 [9.4%] three times antral lavage was done in all 100 patients. Out of 100 patients 33 got no benefit and underwent for intranasal asntrostomy along with selected 50 patients. Every patient was followed up for 2 weeks. Antral lavage showed 67% benefit and 33% patients got no benefit while intranasal antrstomy followed up patients got 90% benefit and 10% got no benefit This study shows that results of intranal antrstomy is better than antral lavage

Snake bite, types and its effects on humanbeings

Objective of this study is to know types of snakes bite, First Aid treatment and removal of fear from patients. Descriptive and observational type of study. This study was carried out at PAF Bases in southern areas, Pirpatho, Mirpur Khas and Nawabshah from 1st Jan to 31 Dec 2005. PAF personnel and civilians of the area bitten by the snakes were included in this study. 75 patients were of vipredee bite and four were Cobra bite and neurotoxic from 1st Jan, 2005-Dec, 2005. Patients were admitted/detained in Medical Investigations Rooms at various Bases of Pakistan Air Force. 70 patients brought dead snakes with them whereas 09 patients could not bring the dead snakes with them. Their clotting time was taken, and observed for signs of envenomation. The clinical features like edema was present in 29 patients, bleeding from bite site was in 79 patients, Pain was in 79 patients, Vomiting was in 13 patients, Fever in 02 patients, no bleeding patches were seen in patients, Clotting tune was raised in 30 patients and Drowsiness in 04 patients were observed. Four patients died, all four were of neurotoxic bite. In 35 patients t heir BT,CT was taken, detained till their BT,CT become with in normal limits. 44 patients developed signs of envenomation and CT was between 10-30 minutes patients having CT 10 minutes [11 patients] were given one vial of 50ml ASV in 500ml dextrose saline water. CT become normal with in two-days, patients having CT with in 20 minutes [25 patients] 2 vial of 50ml ASV in 500ml of dextrose saline were given. CT became with in normal limit after one week. Patients having 30 minutes CT [07 patients] were given 3vial of 50ml ASV in 500ml of dextrose water remained hospitalized for one week in Medical Investigation Room and CT become normal with in one The patients bitten by neurotoxic snakes were given 50ml of ASV, 1cc of TT, Inj.Solucortef, Oxygen inhalation, IV route maintained by 10% dextrose water, were transferred to main Hospital where they were put on ventilator and could not survive. Patients whose CT was with in normal limits were detained and observed for two days assurance was given to them and were discharged after two days. Urine R/E, FDP, PT PTTK, Platelets count and fibrinogen level were not taken due to non-availability of facility in the field. It was noted that patient bitten by viperadee snakes 75 [95%] and 4 [5%] patients were bitten by Cobra snakes. The vipradee bites were hemotoxic and 35 patients does not developed signs of envenomation 44 patients developed signs of envenomation and 4 patients were bitten by Cobra snakes they developed signs of envenomation and were transferred to main Hospital for management. 04 patients died in Hospital and 02 patients were sensitive to ASV and they were treated under high doses of steroid and antihistamine. The patients of snake bite can be treated effectively even in remotest areas and the patients bitten by neurotoxic snakes should be given first aid and then evacuated as soon as possible to nearest main hospital where laboratory facility to tory failure are to be managed properly. When patient is sensitive to ASV under high doses of steroid ASV should be given in presence of Adernaline and anti histamine injection

Anemia in pregnant ladies in a segment of Malir cantonment area

To determine anemia in pregnant women, causes of anemia and its treatment. Observational descriptive study. The pregnant ladies reported in antenatal clinic their hemoglobin%age, their history and clinical examination were recorded. Other factors causing anemia were excluded in history and clinical examination [Kidney, Liver, Collagen, Worm infestation, Malaria and other blood loss were excluded from this study]. The socio economic condition was, the head of family was earning 4000-10000Rs per month. 100 pregnant women were included in study, their Hb%, Red cells morphology and absolute values, Blood count, Peripheral blood count, History clinical examination and U/S abdomen were used for evaluation of Anemia. This study was carried out at Anti-Natal clinic in segment of Malir cantonment area from 1st January to 31st December 2005. The population of this segment is 17000 in which 100 pregnant women of Age 20-42 Grivida. 1-4 and trimester 1st to third trimester were included in this study. Ages of 20, women were of range 20-21 years [20%], 40 were of range 30-35 years of age [40%], 30 were of 35-38 years of age [30%] and 10 were of 38-42 years [10%]. The hemoglobin%age in 20% of women was above 11.0g/dl and 80% women were having Hb% less than 11.0g/dl. 60 women reported in first trimester and their Hb% varies between 9-11%, 20 women reported in second trimester their Hb% was 7-9% and 20 women reported in third trimester and their Hb% was 7-8%. It is concluded that pregnant ladies of a segment of Malir Cantonment area are suffering from nutritional anemia. Iron deficiency anemia 70%, Foliate anemia 20%, Mixed anemia 10% and their hemoglobin%Age improved on oral anti anemic drugs [Fersolate, Folic acid and Multi vitamin] for the duration of six week and their hemoglobin%age came with in normal range