Outcome of neonatal tetanus in hospitalized patients

To determine the outcome of neonatal tetanus in hospitalized patients. A hospital based cross sectional study. This study was conducted in Children Hospital Quetta from April 2011 to March 2012. A hospital based cross sectional study was conducted to determine the outcome of neonatal tetanus. 60 full term neonates from 0 to 28 days of age were included in the study after fulfilling the criteria of tetanus. Diagnosis was established exclusively on clinical grounds. Mean age of presentation was 7.5 days, male female ratio was 3:1. Most common presentation was generalized seizure in 51. 5% cases, 30.1% presented with lockjaw, 15.1% presented with opisthotonos and only 03. 3% presented with poor sucking. 92% mothers were illiterate, 85% belong to the low socio economic status, 78% were from rural area, 75% delivered at home, immune status was low in 70% mothers, cord was cut by non sterilized equipments in 65%, cord was tied with unclean thread in 60%, unhygienic material was applied to the cord in 54%, and 25% developed tetanus after circumcision done by non sterilized instruments at home. 25 out of 60 neonates died and the overall mortality rate was 40.1% out of 60 cases, 24 were put on ventilator and 9 of them [37.5%] died, while out of 36 unventilated cases 16 [44.4%] died. The findings of the study demonstrate that the high mortality rate of neonatal tetanus is due to lack of knowledge of risk factors. Lack of maternal education, low immune status of mothers against tetanus along with unsafe and unhygienic delivery practices are major risk factors responsible for the development of neonatal tetanus

Comparison of the complication between the radical neck dissection and selective neck dissection for the patient of oral squamous cell carcinoma

To compare the outcome of the radical neck dissection and selective neck dissection for control of the disease in those patients who have their nodal involvement localized to level I, II, III. Prospective Randomizing Study. This study was conducted in Oral and Maxillofacial Surgery Department, Mayo Hospital, Lahore from 1[st] January to 31[st] December 2001. The study was conducted in dental section, Mayo hospital, Lahore. Thirty patients of squamous cell carcinoma of oral cavity were selected and randomly divided into two groups. Group I was subjected to selective dissection of the tumour while group I was subjected to radical neck dissection. Postoperative complications were recorded each follow up visit. Post operatively, in group I secondary hemorrhage occurred in 26.7% while in group II, it occurred in 40.0%, group I showed delayed healing due to infection in 46.7% while in group II, it was 73.3%. In group I and group II, there was no recurrence after 1 month, 3 month and 6 month. After 9 months recurrence was noted in groups. It was 20% in group I while 6.7% in group II. Selective-neck dissection should be preferred in the patient of oral squamous cell carcinoma with level I, II, III lymph node involvement as compared to radical neck dissection however recurrence rate is higher in patients undergoing selective neck dissection as compared to patients undergoing radical neck dissection

Co-relation of dietary and circulatory calcium on bone mineral density in female population of Quetta

To determine the prevalence and severity of low bone density in the females of Quetta city and find out its co-relation with dietary factors and blood calcium level. Descriptive Correlation study. Two hundred women from all ethnic groups which included mixed population of Pathans, Balochi, and settlers [residing from last 30-65 years] of Quetta city were randomly enrolled in this study. A sample of 200 adult healthy women, residents of Quetta city, aged 20-80 years were randomly selected to participate in the study. Blood calcium level was determined by Blood biochemical auto analyzer and bone mineral density of these subjects was measured by bonesonometer. A questionnaire was used to collect dietary, sociodemographic, age, dietary factors and other relevant detailed information affecting bone mineral density [BMD] status of women. Amongst all the subjects 66 [38%] were osteopenic, 17 [8.5%] and 117 [58.5%] were normal. T-score was positively correlated with milk, [p<0.01] and negatively correlated to age [r=-0.61, p<0.01], junk food and women bearing more than four children. BMD decreased with increasing age and low BMD was found to be more prevalent in women above 45

Prevalence and correlation of osteoporosis with different risk factors

To determine the prevalence and severity of low bone density and its correlation with different risk factors for osteoporosis in Quetta. Descriptive cross sectional study. This study was conducted in the suburbs and urban setup of Quetta from February, 2009 to March, 2009. A total of 212 females ranging from 18-72 years of age were selected. The subjects were interviewed regarding dietary calcium, socio-economic conditions and the associated diseases, and risk factors for osteoporosis. The calcaneal bone density of the subjects was measured using Bone Sonometer. Data was employed to differentiate between osteopenic and osteoporotic women and to analyze the results statistically. Risk factors for osteoporosis were highly prevalent. Many rural area subjects were current or former smokers [45%], and were negatively correlated [-.234] with low bone density. Total dietary calcium intake from both the localities was much lower than recommended. Subject with normal bone mineral density [57%] were prevalent, with 56% in rural area residents and 58% in urban area. Amongst all the subjects, 24% were osteopenic, [18% in rural area and 30% in urban area; 19% had osteoporosis with 26% in rural area and 12% in urban area. T-score of all the subjects was positively correlated with physical acitivities and total calcium intake, [p<0.01] and negatively correlated to smoking [r= -0.234, p<0.01], bone fracture history [r=-0.311 p<0.01], junk food especially in the young women of urban locality and old age. The mean t-score of Killi natives was 1.3 compared to an average t-score of -0.9 for urban natives. The risk factors for low bone density and osteoporosis are prevalent in both urban and rural women and are likely to increase during the next decade due to the aging of this population. A comprehensive prevention program to reduce the prevalence of amendable risk factors in this population is necessary

Frequency of thrombocytopenia in children suffering from Malaria

To determine the frequency of thrombocytopenia in children suffering from malaria. Descriptive Study. This study was carried out in pediatric department of Bolan Medical College Quetta during 18 months from April to October 2011. A total of 140 malaria parasite positive on peripheral film children from 6 months to 7 years of age hospitalized due to febrile illness were included in the study. Hematological parameters were determined by using automated analyzer. Those with reduced platelets count were reevaluated by manual method. Thick and thin smear stained with Giemsa for malaria parasite was studied by hematologist. Mild thrombocytopenia was labeled with platelets count < 150,000 to > 50,000 /cumm, moderate with platelets count of < 50,000 to > 20,000/cumm and severe with platelets count < 20,000/cumm. Out of 140 malaria parasite positive children, 100 [71.4%] had thrombocytopenia while 40 [28.6%] had normal platelets count. Mild thrombocytopenia was common in p falciparum 40% as compared to 14% in p vivax. Moderate and severe thrombocytopenia was common in p vivax 28% and 4% against p falciparum 12% and 2% respectively. 94 [67.1%] were male and 46 [32.9%] female. Thrombocytopenia was found to be significant in children suffering from malaria. Mild thrombocytopenia was common in p falciparum but the moderate and severe thrombocytopenia was common in p vivax

Frequency of cardiac defects among children at echocardiography centre in a teaching hospital

To assess frequency of cardiac defects among children from birth to 12 years of age on echocardiography basis. A cross sectional study was conducted at echocardiography centre in coronary care unit at Bahawal Victoria Hospital Bahawalpur for fifteen months from April 2007 to July 2008. A sample of 150 patients [<12 years age] were selected by non-probability convenience sampling technique. The cardiologists performed echocardiography by Paediatric Transthoracic echo probe; 2-D colour Doppler, Acuson CV-70 and Niemo-30 echocardiography machines. Mothers of children with cardiac defects were interviewed at the echocardiography centre. Variables included were A- Muscular plus Vascular defects; B- Valvular defects; C-Pericardial effusion; D- Dextrocardia and E- Congestive cardiac failure. History of children for sore throat followed by joint pains; history of mothers for drug intake [antihypertensive, antipyretic, anti-emetic, hypoglycaemic] as well as chronic diseases [diabetes mellitus, hypertension, anaemia] during pregnancy were surveyed. Parity of mothers, their cousin marriages, and family socio-economic status was also inquired. The results were tabulated, analyzed and finally subjected to suitable test of significant [SR of proportion] to find out statistical significant if any. It was found that out of 150 patients, 76 [50.66%] were suffering from Cardiac muscular and Vascular defects, 61 [40.66%] Valvular defects, 7 [4.66%] Pericardial effusion, 2 [1.33%] Dextrocardia and 4 [2.66%] from Congestive Cardiac Failure. According to age, 54 [36%] were from birth to 3 years of age and 51 [34%] from 10 to 12 years. There was history of Rheumatic fever among 45 [30%] children. There were 106 [70.6%] children from lower socio-economic class and 79 [52.6%] parents had history of cousin marriages. Frequency of cardiac defects was more in children of male sex, lower socio-economic group, from birth to three years age and children from primipara mothers in our specified locality. Rheumatic fever, cousin's marriage, and prescribed drugs intake during pregnancy [for metabolic and hormonal disorders] were other contributors to cardiac defects

Association of iron deficiency anemia and worm infestation in school children [5-10 Yrs] in Quetta

To determine the association of iron deficiency anemia and worm infestation in school children [5-10 Years] in Quetta. This case control, randomy study was carried in 9 schools of Quetta from March till July 2009. A total of 600 children were examined, 200 each from private, Government and non formal schools [Madrassa] for anemia. Iron deficiency anemia was confirmed on CBC, retics count, peripheral smear, RBCs indices and serum ferritin level. Hb<11.5 gm/dl, CMV<25 fl, MCH<75 fl and farriten<20 nm were the cut of points. History of worm infestation was conformed by parents and children. Out of 600 children 70 were anemic, of which 30 were positive for anemia and worm infestation both, 40 were anemic without worm infestation and 87 had history of worm infestation without anemia Worm infestation in anemic children was 3.8 times greater as compared to non anemic children

Comparison of oral hygiene status and practices among male and female students of Bolan Medical College Quetta

The objective of present study was to determine the oral hygiene status and behaviors in male and female students of Bolan Medical College Quetta. A self administered questionnaire was distributed among 114 students comprising of 67 male and 47 females regarding the use of oral health maintenance tools and frequency of their use. The students were examined in dental chair to establish their oral hygiene status as Good, Fair and Poor. Female students had significantly better tooth cleaning habits than the male students. 85% females brushed their teeth twice daily, as compared to 28.3% males. However no significance difference [p>0.05] was observed between the oral hygiene status of male and female students. Female students have better oral hygiene habit, as compared to males. More gender specific studies on oral hygiene habits are required in Pakistan

Variations in blood glucose and lipid profile during Ramadan fasting in male

The purpose of study was to evaluate the effect of Ramadan Fasting on blood glucose and lipid profile. 30 healthy, non-obese, non-smoker, male volunteers who observed fast during the whole month of Ramadan were included in the study. Blood samples were collected aseptically by venipuncture from all subjects on day 1, 10, 20 and 29 of Ramadan. Blood glucose, Cholesterol, HDL-c, LDL-c and TAG tests were conducted on serum. The study was carried out during October-November/2005 at Abbottabad, Pakistan. Blood glucose, Cholesterol, TAG and LDL-c levels decreased significantly while HDL-c level rose considerably at the end of Ramadan. The beneficial changes observed during the month of Ramadan can be maintained if the dietary habits of Ramadan are continued onwards

Audit of hysterectomy for benign pelvic diseases

The purpose of the study was to determine the frequency, Indications, complications of different types of hysterectomies and correlation with age and parity of the patients who underwent hysterectomy for benign pelvic disease. This study was carried out at Gynae Unit-II Bolan Medical Complex Hospital Quetta from September 2004 to March. 2006 for 18 months. Chart review was conducted during the study period for all patients who had hysterectomies for benign pelvic disease. 210 hysterectomies were performed during the study period out of these 163 [77.62] hysterectomies were carried out by abdominal route. Vaginal route was opted in 47[22.38%]. of cases and all the patients were having utero vaginal prolapse. The ratio of Abdominal to Vaginal Hysterectomy was 3.8:1. Dysfunctional uterine hemorrhage was the commonest indication of abdominal hysterectomies 57 [27.14%] followed by chronic PID 50[23.80%] fibroid 36[17.14%]. Majority of cases of fibroid Were in low parity and prolapse in high parity group. Majority of patients 179 [85.23%] were more than 40 years of age and 120[57.14%] were para 7 and above. Most of the women undergoing hysterectomies were between the age group of 41-45 years 80 [38%]. Overall complication rate was 44.6% higher in abdominal than Vaginal hysterectomy These Included wound infection 23[10.95] paralytic ilieus 19[9%]. UTI 17[8%], unexplained fever 15 [7.14%], and DVT 5 [2.38%] DVT was common in obese and those reluctant to ambulate. it is concluded from the present study that Vaginal Hysterecomy is associated with less morbidity and complication therefore well experienced Gynecologist should encouraged the vaginal route over the abdominal. Every tertiary level hospital should have the facility of hysterosocopic procedures for management. of DUH and fibroid

Trace elements in drinking water in district west of Karachi

Several trace elements are present in drinking water. They play various important roles in the body, provided their level remains within the specification/ recommendation given from time to time by WHO. The study was carried out during the year 2005. Drinking water samples were collected from different sources and localities of District West of Karachi. After collection of samples, the concentration of the trace elements i.e. Lead, Arsenic, Copper, Iron, Mercury, Chromium, Manganese, Nickel, Cadmium and Zinc were determined by Atomic Absorption Spectrophotometry. Concentrations of lead and nickel were found to be highly significantly elevated as compared to WHO recommended levels in all the three sources of water [Piped water, Hand pump water and Tanker water supply] in District West of Karachi. Chromium was found to be raised as compared with the WHO recommended level in hand pump water of District West. Arsenic and Mercury were not detected in any source of water in District West. Copper, iron, manganese, cadmium and zinc were found to be within the safe limits set by WHO in all the three sources of water of District West. Concentrations of lead and nickel were found to be highly significantly elevated as compared to WHO recommended levels in all the three sources of water [Piped water, Hand pump water and Tanker water supply] in District West of Karachi. Chromium was found to be raised as compared with the WHO recommended level in hand pump water of District West