Dengue fever; an audit of risk factors among patients reporting at a tertiary care hospital in Hyderabad

Background: Dengue fever and its complications have become a nightmare for common people in Asian countries including Pakistan. Besides environmental factors responsible for its transmission, there are many host factors too involved in its rapid spread

Objective: To assess risk factors for dengue fever among patients reporting at Liaquat University Hospital [LUH] Hyderabad. Study Design, Setting and Study duration: Descriptive cross sectional study was conducted at LUH, Hyderabad for six months i.e. from 15[th] May 2013 to 15[th] November 2013

Methods: 481 patients were registered through convenient sampling after informed verbal consent. Patients' demographic features, clinical presentations and laboratory reports were collected on a preformed proforma

Results: The reporting rate for dengue fever was 18.5% and the mean age of presentation was 28.5 +/- 3.5 years. Males were in majority [72.55%] 3 and the average days of admission were 4.5 days; low platelets count [< 50,000/mm[3]] was recorded in 72% of cases; however 11.64% patients presented with hemorrhagic tendency. Age was strongly associated with thrombocytopenia [p=0.04] and with occurrence of hemorrhage [p=0.03] in both genders; this association was more evident among males [p=0.01]. However among uncomplicated cases no association was evident between gender and length of stay in [p=0.35]

Conclusions: The alarmingly higher reporting rate of dengue fever necessitates contextual preventive interventions. As younger age and male gender are the major risk factors for this disease; therefore age-specific and gender-specific preventive strategies against this disease are recommended

Self medication practices among residents of slum areas of qasimabad, Hyderabad

Self medication is the practice of treating ailments with medicines which are available without prescription. There is a lot of public and professional concern about the irrational use of drugs. To assess self medication practices among residents of urban slum areas of Taluka Qasimabad, District Hyderabad and to determine the underlying factors for it. A community based descriptive cross sectional study. This study was carried out among residents of peri-urban areas of Taluka Qasimabad, District Hyderabad from 15[th] October 2012 to 15[th] December 2012. Study tools, sample size and sampling technique: Data was collected through questionnaire based interviews from responders. Three hundred and eighty five responders were selected by convenience sampling. The prevalence of self medication was calculated in percentage. The qualitative and quantitative variables were analyzed in SPSS version 16 by applying various tests of significance. Total three hundred and eighty five respondents participated in the study; among them 207 were practicing self medication. 57% of the subjects were in age group 18-30 years [p=0.04]. There was male preponderance [90.3%] showing significant association with self medication practice [p=0.01]. Easy availability of medicines was the main reason for self practice [62.8%]; various analgesics were the most commonly used drugs [58.5%]. Self medication is the common practice among peri-urban residents; availability of low cost drugs is one of the most important determinants for this practice

Maternal age and parity as risk factors for preterm births and low birth weight among newborns delivered in outskirts of district Mirpurkhas

To estimate the frequency of preterm births and low birth weight occurring in union council Jhudo, District Mirpurkhas. To seek association of preterm births and low birth weight with maternal age and parity. Descriptive cross sectional. This study was conducted at Union council Jhudo, District Mirpurkhas. From June 2012 to September 2012. Three hundred households having a new born of age upto seventy two hours. Subjects were selected through convenience sampling method. Among total of three hundred, the frequency of preterm births was 37 [12.33%]; while the frequency of low birth weight was 83 [27.66%]. All the preterm babies were low birth weight. There were 121 women [40.33%] at advanced age, among them preterm delivery was recorded in only 17 women [14.04%] [p=0.16]. Low birth weight babies were delivered to 31 women at advanced maternal age [25.61%] [p=0.04]. Among three hundred recently delivered women, 113 were primipara [37.66%], 98 [32.66%] were multipara and 89 [29.66%] were grand multiparas. Primiparity was seen statistically significantly associated with low birth weight [0.02]; and as parity increased, it did not show significant association with low birth weight.[p=0.12]. Low birth weight and preterm births are still major public health problems in our community. The advanced maternal age and high parity are the risk factors for them in rural and semi-urban areas

Outcome analysis of transvesical prostatectomy in our setting

To evaluate the outcome of suprapubic transvesical prostatectomy in our setting. Prospective and descriptive audit from July 2002 to July 2005. Department of Surgery, Peoples Medical College Hospital, Nawabshah. A total of 120 patients with lower urinary tract obstruction due to benign prostatic hyperplasia [BPH]. The details of all the above mentioned patients were recorded and the data analyzed for age, presentation, accompanying problems, blood transfusion, hospital stay, complications and mortality. The age range of the patients was from 50-90 years, mean age being 64.73 years. The indications for surgery were retention of urine in 64 [53.33%] cases, prostatism in 53 [44.17%] and haematuria in three [2.5%] cases. Associated problems were seen in 73 [60.83%] patients, including bladder stones in 19 [15.83%], inguinal hernia in 15 [12 .5%], haemorrhoids and renal stones in four [3.33%] each, and medical problems in 30 [25%] patients. The average operation time was 67.5 minutes and 51 patients needed blood transfusion [1-3 units]. Complications were seen in 49 [40.83%] cases including haemorrhage and urinary tract infection in eight [6.67%], clot retention in six [5%], wound sepsis in seven [5.83%], and transient incontinence and suprapubic urinary leakage in five [4.17%] cases each. The post-operative mortality was in 1.67% [two cases]. Transvesical prostatectomy [TVP] performed under spinal anesthesia is a safe and effective way of managing BPH. Its success has a durable effect and is a satisfactory modality in situations where facilities for transurethral resection of prostate [TURP] are not available

Pattern of acute pancreatitis: the Liaquat University hospital experience

To determine the aetiological factors, presentation and management of acute pancreatitis and to assess the outcome of different forms of management in our set up. A case series. Liaquat University Hospital, Jamshoro/Hyderabad - Sindh from January 2002 to December 2004. The data of 45 consecutive patients admitted with acute pancreatitis was collected through a proforma and assessed with reference to aetiological factors, clinical presentation and management in each case. Majority [60%] of the patients belonged to 30-40 years of age. Thirty-six [80%] patients presented in emergency. The most common aetiological factor for acute pancreatitis was gallstones and the pain, nausea and vomiting were the main symptoms. Serum amylase [>3 x normal] was seen in 36[80%] patients. Prediction of severity was identified through Ranson score. It was <3 in 27[60%], 3 in 13[28.9%] and 4 in 5[11.1%] patients. The mortality was 13.33% but the morbidity remained high with the sequelae of resolution in >50% cases. Acute pancreatitis in our set up shows a lower frequency of this disease when compared to the world literature. However, when compared with aetiology and presentation, the pattern remains the same. Meanwhile, due to adoptation of Western way of life, the incidence seems to be increasing. Due to patient's delayed arrival, the diagnosis depending upon the level of serum amylase seems to be misleading

Malignancy in nodular goitre

To highlight diagnostic difficulties and evaluate the outcome of malignancy in nodular goiter. Case series. This study was conducted in the Surgical Unit-III and Unit-IV at Liaquat University Hospital Jamshoro, from January 2001 to December 2004. Nodular goiter patients admitted for treatment were studied with the help of a pre-designed proforma for recording the personal history, blood chemistry and FNAC results. The results of FNACs were further compared with the tissue histology postoperatively. During the four year study period 14 patients had malignancy out of total 149 cases of nodular goiter admitted. Twelve patients were diagnosed on FNAC. These patients were operated and near total thyroidectomy was done. Two patients diagnosed to have carcinoma on tissue biopsy [FNAC did not pick the malignancy] were re-admitted and had near total thyroidectomy. One patient with lymphoma was referred to Department of Oncology for radiotherapy. All patients with neoplasm postoperatively were referred to oncology department for further management to suppress the TSH. Near total thyroidectomy is the surgery of choice to decrease the recurrence rate in thyroid malignancies