ABSTRACT
Objective: To assess the diagnostic accuracy of Typhidot test in patients with acute febrile illness taking blood culture as gold standard
Study Design: Cross-sectional validation study
Place and Duration of Study: The study was conducted at Combined Military Hospital Kohat, from Mar 2016 to Oct 2016
Material and Methods: In this study 211 patients with acute febrile illness were included. All patients had Typhidot IgM test done along with blood cultures, blood counts, chemistries and relevant diagnostic tests. Patients were divided into two groups based on blood culture results and both groups were compared in terms of positivity for Typhidot. Sensitivity, specificity, positive predictive value and negative predictive value were calculated using SPSS v 20. Chi square was applied to assess the association between Typhidot and blood culture results
Results: Out of total 211patients, 49 patients had typhoid fever [culture positive] and 162 had non-typhoidal illnesses [culture negative]. Typhidot IgM was positive in 47 [95.9percent] cases of typhoid fever and in 155 [73.5percent] cases of non-typhoidal fevers. The sensitivity of Typhidot for diagnosis of typhoid fever was 95.9percent and specificity was 26.5percent
Conclusion: Our study reveals that Typhidot IgM has high sensitivity for typhoid fever but specificity and diagnostic accuracy are very low. Nevertheless, a high negative predictive value means it can help rule out the disease in suspected cases
ABSTRACT
Objective: The objective of the current study was to report the surveillance of endemic measles in district Bannu and its peripheries
Study Design: Observational / descriptive study
Place and Duration of Study: The study was conducted in Women and Children Teaching Hospital Bannu and various BHUs and dispensaries of countryside's of the district from Jan, 2016 to March, 2016
Materials and Methods: Patients up to 16 years old were screened for febrile rash illnesses at women and children teaching hospital district Bannu and BHUs/dispensaries. Active measles cases were classified as measles, measles with eye and mouth complications, or severe complicated measles using IMCI criteria.16 most critical patient's blood samples were sent to CMH hospital laboratory Peshawar, KPK for further confirmation where test was done by ELISA technique utilizing IgM antibodies
Results: Results showed that male children were highly infected than female. Children from 1-3 years were most affected, followed by children with 1 to 12 months. Least no of cases were reported in children from 4-8 years. Bannu city surrounded areas like mammashkhel, shiekhan, surrani were more affected from measles outbreak while nearby areas are at constant threat
Conclusion: It is concluded that the peripheries were more affected from measles outbreak while nearby areas are at constant threat. In light of our findings, it can be stated that proper steps should be taken by government and non- government organization to control the situation in affected areas and to prevent the nearby areas specially the city from the current outbreak
ABSTRACT
Objective: To determine the frequency of medical covers and diseases encountered in the field by a field medical unit of Pakistan Army
Study Design: Descriptive study
Place and Duration of Study: The Study was conducted in 61 Medical Battalion Multan, from Jan 2013 to Dec 2013
Patients and Methods: All the medical help demanded either in the form of nursing assistants [NA] or medical officers [MO] or advanced dressing station [ADS] or forward treatment centre [FTC], by a competent authority of HQ Log 2 Corps, during complete one year of 2013 [January 2013 to December 2013]
Results: A total of 90% of all medical covers were in-station and 95% of them required NA only. Ten percent of all medical covers were out-station and 98% of them required MO also. Eighty percent of the diseases faced in field were gastroenteritis, 15% upper respiratory tract infection [URTI], 5% were heat exhaustion, trauma, foot rot, arthropode/vector borne diseases
Conclusion: Prompt first aid and speedy evacuation is the essence of medical cover. Basic life support [BLS] trained nursing staff and speedy, reliable and fast ambulance is the core of medical evacuation. MO is only to be employed where distance from any other medical or surgical facility is more than 2 hours. Water source in field to be screened for coliform count under responsibility of concerned engineer detachment or packed water bottles to be provided from the supply detachments
ABSTRACT
Objective: To understand the impact of platelet associated immunoglobulin G (PAIgG)/platelet associated immunoglobulin M (PAIgM) on severity of dengue virus infection leading to thrombocytopenia. Methods: In this study we examined a total of 52 patients who were having secondary infection of dengue in acute phase by using competitive ELISA. Results: A decrease in the platelet count was observed at the acute phase of infection while all along the recovery stage the count of platelet was significantly increased. A significant decrease was observed in PAIgG and PAIgM in these subjects. Inverse correlation was found between platelets count and PAIgG/PAIgM among the subjects studied. In the platelets elution from ten subjects, anti-dengue virus immunoglobulin G and immunoglobulin M were observed. PAIgG and PAIgM with inclined levels were higher in dengue hemorrhagic fever than the classical dengue fever. In the development of dengue hemorrhagic fever PAIgM inclined level was independently associated with high specificity, showing a possible indication of dengue hemorrhagic fever. Conclusions: This study suggests that in secondary dengue virus infection, the PAIgG and PAIgM levels, and the activity of anti-dengue virus play key roles, both in the development and severity of the disease.
ABSTRACT
This article reviews the most prevalent sensory illness of mammals especially humans - Genetic Deafness or hearing loss [HL]. For genetic hearing loss more than 100 candidate genes have been discovered. The most common candidate gene of these all that is found all around the world is GJB2 gene. Different types of mutations are found in GJB2 gene. Some of these mutations are non-sense while some are sense mutations. This study is focus on mutation in GJB2 gene and its prevalence in different region of the world
Subject(s)
Humans , Deafness/genetics , Genes , MutationABSTRACT
Objective: To determine the complications and visual outcome of intraocular foreign body presented to a tertiary care centre of Khyber Pakhtunkhwa
Study Design: A prospective, interventional case Series
Place and Duration: At Department of Ophthalmology, Govt Lady Reading Hospital, Peshawar from 1st July 2011 to 31st Jan 2013
Methodology: 37 cases with intraocular foreign body from outdoor department were admitted for management. Patients were examined after detailed history and important findings noted
Results: The study population comprised of 37 cases. Male were in majority [70.2%]. majority of our patients were young. Mean age 33 years. Common complications of intraocular foreign body include vitreous hemorrhage [32.4%], retinal detachment [37.8%], scleral perforation [32.4%] and endophthalmitis [27%]. Visual progression was poor in majority of the eyes [54.04%]
Conclusion: Most serious cause of intraocular foreign body was Bomb Blast injury. Visual prognosis was poor in majority of the eyes; delayed presentation and complicated BBI were the top reasons
ABSTRACT
Background: Cryptosporidium parvum and Giardia lamblia are intestinal parasites that predominantly causes "waterborne" infections that are transmitted through consumption of contaminated water. Both parasites typically cause an acute short-term infections with selflimiting diarrhea as the main symptom in people with intact immune systems. However, in immunocompromised individuals, the symptoms are particularly severe and might be fatal. Methods: The study was carried out in District Bannu Khyber Pukhtunkhwa, Pakistan for the detection of G. lamblia and C. parvum parasites in drinking water in different villages/localities (Kakki, Jamon Road, Kotka Juma Khan, Sokari, Mandan and Bannu City). Water samples n=75 were collected from different water sources between 1st August 2011 to 30th January 2012. These samples included tap, pond, borewell and hand pump water that were filtrated and residue was subjected to amplify by PCR. Results: Overall prevalence of parasites was 36% (25/75), containing tap 17.64% (9/51) and pond water 75% (6/8), bore well water 41.66% (5/12) and hand pump water 50% (2/4). Similarly over all prevalence rate of tap water for C. parvum was 7.84% (4/51) while for G. lamblia was 9.80% (5/51) positive. The present study revealed that the people of the area should use the cleaned and filtered water. Conclusion: Contamination of water with G. lamblia and C. parvum was found in water sources especially the drinking ones, of District Bannu which need proper water treatment to decontaminate and large scale studies are needed.
ABSTRACT
Treatment of recurrent sigmoid volvulus is a major challenge in frail and elderly patients with multiple co-morbidities. Early management involves endoscopic decompression with high success rate, however, its recurrence make it a real challenge as most of these patients are not suitable for major colonic resection. The aim of this study was to assess the role of percutaneous endoscopic colostomy [PEC] in the treatment of recurrent sigmoid volvulus in these patients. Twelve PEC procedures were performed in 8 patients under our care. This prevented major colonic resection in 7 patients. One patient underwent sigmoid resection and died with postoperative complications. Two patients experienced minor complications. Three patients required repeat procedures for permanent PEC tube placement. Six patients managed permanently with PEC procedure. PEC is an effective treatment for recurrent sigmoid volvulus in high-risk elderly patients.
Subject(s)
Humans , Male , Female , Aged, 80 and over , Endoscopy , Intestinal Volvulus , Colon, Sigmoid , Recurrence , Frail Elderly , AgedABSTRACT
Lipomas of gastrointestinal [GI] tract are the common benign tumours. They are usually small and asymptomatic; however, large colonic lipoma is a rare tumour and may cause intestinal obstruction. A similar rare case of large lipoma, treated with laparoscopic right hemicolectomy, is reported here
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This study was conducted to determine the safety and efficacy of injectable bulking agents. A total of 13 procedures were performed on 11 patients with faecal incontinence during 2002 to 2007. Patients with internal anal sphincter defect and low incontinence score [Cleveland score < 10] revealed improvement. Patients with higher incontinence score and external sphincter defect secondary to obstetric damage required further intervention. At a median follow-up of 43 months, 7 [63%] patients showed improvement in incontinence score and 4 [32%] showed marked improvement in their symptoms. Fifty six percent of the patients described this as an effective procedure, though the level of effectiveness varied from person to person. Anal injectable collagen was found safe and effective in the management of faecal incontinence. Long-term follow-ups are required to re assess and consider definitive procedure in failed cases
Subject(s)
Humans , Male , Female , Injections , Anal Canal/abnormalities , Anal Canal/diagnostic imaging , Collagen , Pain Measurement , Retrospective Studies , Treatment OutcomeABSTRACT
Present study is carried out to compare laboratory diagnostic methods of Cutaneous leishmaniasis [CL] for the outdoor patients of Bolan Medical College Complex Hospital, Quetta, Balochistan. From November 2005 to December 2007, three hundred cases of CL patients were selected without restriction of age and sex. The lesions were divided into two groups. Early with duration less than 2 months and late duration between 2 to 4 months and were noted as nodules, plaques, ulcers and scarring [in case of relapses]. Skin smears were taken on first visit of the patients, followed by skin biopsy for histopathological examination. Result showed that out of 300 cases 163 [54.33%] were positive smears for Leishmania donovani [LD] bodies and 137 [45.67%] were negative smears for LD bodies.. While histological examination of all 300 cases showed that only 83 [27.66%] cases were negative for [LD] bodies and no granuloma seen, except with evidence of acute and chronic inflammation. Further analysis of histological observations of positive cases [72.34%] revealed that 91[30.33%] cases had LD bodies,, 78 [26%] cases had only necrotic sloughs showing polymorph neutrophilic infiltration, and 48[16%] cases were having granulomas composed of, epithelioid cells Langhan's type of giant cells and lymphocytes. It is therefore concluded that histopathological examination as compared to skin smears method is more sensitive method for diagnosis of CL