ABSTRACT
Background: A relatively effective method for the management of acute malnutrition in severely malnourished < 5 year children is their management according to WHO guidelines in stabilization centers where they are admitted with medical complications
Objectives: To improve the nutritional status of complicated malnourished children before their discharge from stabilization centers. Study design, settings and duration: Hospital based, exploratory study conducting in stabilization centers at Ghotki and Larkana. Sindh from September to November 2015
Subjects and Methods: By using universal sampling technique, all children who were enrolled and completed their treatment in October 2015 in the stabilization centers at Ghotki and Larkana, Sindh were included in the study. The parameters recorded included weight, length/height, mid upper arm circumference, heamoglobin level [both at the time of admission and discharge] while for nutritional rehabilitation, therapeutic milk F75 and F100 were given
Results: Total 78 children were enrolled for treatment in stabilization centers. Their average length of stay in stabilization center was 7.1 days. The average weight gain was found to be 9.028 [+/- 3.956]gm/kg/day which was statistically significant. The mean gain in the mid upper arm circumference, weight for height, body mass index and hemoglobin level at the time of discharge were also statistically significant [p < 0.000]. Height did not show any significant change
Conclusion: The findings of this study indicate that management of severally malnourished children in accordance with the international standards resulted in significant improvement of nutritional status of children
ABSTRACT
Objective: To determine the visual outcome of laser treatment in clinically significant macular edema
Methods:This interventional and qausi experimental study was carried out at Diabetic Association of Pakistan [DAP] during January 2011 and December 2012. Approval was taken from Research Ethical Committee of Isra Postgraduate Institute of Ophthalmology. Records of 925 eyes of 464 patients with "Clinical Significant macular edema" [CSME], treated with laser photocoagulation were analyzed. Bestcorrected visual acuity [BCVA] at the time of presentation and at the last follow up, minimum of one year and maximum of 45 months was recorded and compared. SPSS version 20.0 was used to analyze the data
Results:Diabetic retinopathy was found in 20.3% [1777] of 8742 diabetic attending DAP Hospital" amongst whom 39.6% [705] had Sight threatening diabetic retinopathy. Laser was advised in 96.4% [680] individuals, accepted by 70.5% [480] individuals. Amongst 960 eyes of 480 patients who accepted laser, 925 eyes had clinically significant macular edema and 35 eyes had PDR who are not included in this study. Amongst 925 eyes with CSME, Grid laser was done in 913 eyes [99%] and focal laser was done in 12 eyes [1%]. After a follow up of 12 to 45 months, it was found that best corrected visual acuity had declined in 2.4% [22] eyes, stabilized in 67% [619] eyes and improved in 30.7% [284] eyes. One line improvement on Snellen's chart was fond in 21.3% [197] eyes, 2 lines in 8% [74] eyes, 3 lines in 1.2% [12] eyes and 4 lines in one [0.1%] eye with p-value of 0.000
Conclusion:Laser therapy is an effective treatment in stabilizing/improving the vision in diabetic macular edema particularly at those centers where only Argon Laser is available and OCF, FFA facilities do not exist
ABSTRACT
To assess the Knowledge, Attitude and Practices [KAP] towards diabetes and diabetic retinopathy in the general population of Bin Qasim Town [BQ], Karachi. An observational, cross-sectional study was approved by Research Ethical Committee of Al-Ibrahim Eye Hospital. It included every third household by stratified sampling in each Union Council of [BQ] Town, in the months of May to July 2013. The interview Questionnaire included 43 questions, of qualitative and quantitative aspects, which were awarded 56 scoring points. SPSS version 20.0 was used to analyze the data. Six hundred ninety two adults one from each household were interviewed. Of the total respondents, 271 [39.2%] had diabetes. Lowest mean knowledge score [5.28 +/- 6.09] was seen in illiterate respondents. Male's Mean Knowledge score [7.61 +/- 6.600] was better than female's [5.46 +/- 6.21] with P <0.001. Over all mean score of Attitudes towards diabetes was 5.43 +/- 2.57. It was higher [6.62 +/- 2.03] in diabetic respondents as compared with non-diabetic respondents [4.70 +/- 2.59] with p < 0.000. In Practice module majority of the respondents [69.9%] did not exercise, 49% took high caloric snacks between meals and 87% ate outside home once a month, 56.8% diabetics visited ophthalmologist for routine eye examination; but only 9.2% asked for retinal examination. Lack of knowledge of diabetes was found in the surveyed community, more marked in females, illiterate and the individuals not having diabetes
ABSTRACT
Objective: To determine the acceptance of retinal screening, Laser uptake and subsequent follow-up in diabetic patients attending the Diabetes Centre of Diabetic Association of Pakistan [DAP], Karachi
Study Design: Observational case series
Place and Duration of Study: Diabetic Centre of Diabetic Association of Pakistan [DAP], Karachi, from January 2011 to December 2012
Methodology: All the diabetic patients were screened for Diabetic Retinopathy [DR] with non-Mydriatic Fundus Camera [NMFC]. Patients with DR were examined by the ophthalmologist using fundus lens and slit lamp. DR was graded for severity on the basis of modified Airlie House Classification. Patients with Sight Threatening Diabetic Retinopathy [STDR] were advised Laser treatment. Each patient was followed-up for at least 6 months. The records of patients recommended Laser were retrieved, and called for re-examination
Results: Retinal screening was accepted by all of the 8368 registered diabetics attending DAP Centre. On fundus photography, 21.2% [1777] individuals were found to have DR. Seven hundred and five [39.5%] patients were found to have STDR. Laser was advised to 96.4% [680] of STDR patients; amongst whom 70.5% [480] accepted Laser treatment. Out of 480 patients who had Laser treatment, 21.2% [107] turned out for follow-up after 6 months
Conclusion: Acceptance of retinal screening and Laser application was good; but follow-up was suboptional
ABSTRACT
To compare the rate of mortality in fire burn inhalational and non inhalational injuries. Retrospective, comparative study. The study was conducted at Burns centre, Civil Hospital, Karachi from January 2009 to December 2010. The study was conducted on admitted patients at Burns centre, Civil Hospital, Karachi. All male young male patients aged 20 to 40 years admitted in Burns ward [Civil Hospital, Karachi] suffering with fire burn inhalation or fire burn non inhalation injuries with burnt surface area between 20% - 50% were included in this study. Patients were followed until discharged or death. Out of total 300 male, 150 in each group having age between 20 and 40 years with 20% to 50% of burnt surface area and had sustained severe burn injuries admitted to Burn centre were included in the study. Of these, patients with fire burns inhalational injuries were at high incidence of mortality rate i.e. 66/150 [44%] as compared to non inhalational injuries i.e. 42/150 [28%] [P<0.05]. We conclude that patients with fire burn inhalation injuries are at increased risk of death, because in addition to severe cutaneous burns it also causes acute inflammation and damage of the respiratory system
ABSTRACT
To compare the frequency of inflamed appendix in suspected patients of acute appendicitis having Modified Alvarado Score [MAS] of 7 or more with patients having MAS of 6 or below. Comparative cross sectional study. The study was carried out at Surgical Departments of Combined Military Hospital [CMH] and Military Hospital [MH] Rawalpindi from April 2006 to April 2007. This study involved 100 patients who were operated with provisional diagnosis of acute appendicitis. Preoperatively MAS of each patient was calculated and the patients were divided in two groups. Group-l had MAS of 7 or more while Group-ll had MAS of 6 or below. Postoperatively appendices of all the patients were sent for histopathological examination and its result regarding presence or absence of acute appendicitis was then compared with MAS of respective group. [a] Group-l :- A total of 72 patients with 64 [88.9%] positive inflamed appendices on histology. Negative appendicectomy rate 8 [11.1%], [b] Group-ll:-A total of 28 patients with 8 [28.6] positive inflamed appendices. Negative appendicectomy rate 20 [71.4%]. There is statistical significant difference of positive appendicectomy rate between two groups with [p-value<0.001]. Frequency of inflamed appendix is more in patients having MAS of seven or above. The number of negative appendicectomies can be reduced by using MAS in clinical practice
Subject(s)
Humans , Male , Female , Appendicitis/epidemiology , Acute Disease , Sensitivity and Specificity , Cross-Sectional Studies , Preoperative CareABSTRACT
To determine the proportion of Diabetes Mellitus [DM] in patients with documented first episode of Acute Myocardial Infarction [AMI], in both genders. A prospective, case control observational study. Emergency Room, CCU and Medical wards of Chandka Medical College Hospital Larkana, Pakistan, from January 2005 to August 2005. 200 patients 100 consecutive males and 100 consecutive females, presenting with definite first episode of AMI. Diagnosis of D.M established on previous history of D.M, medical record and medications used by patient, patients without previous diagnosis of D.M [Undiagnosed], were diagnosed by performing Fasting Plasma Glucose [FPG], once within around 72 hours and 8 weeks later on. Out of 200 patients 49 [24.5%] were known diabetics, 20 [10%] revealed hyperglycemia [suspected diabetics] on routine plasma glucose level and Fasting Plasma Glucose [FPG] petformed within 72 hours of the onset of AMI and on subsequent follow up after 8 weeks, FPG level performed revealed 12 [6%] newly diagnosed definitive diabetics, while 5 [2.5%] revealed Impaired Glucose Tolerance Test [GTT] and 3 [1.5%] were found to be non-diabetics, so that a total 61 [30.5%] were labeled as diabetics. one out of every three patients with AMI had DM, elevated levels of random blood glucose and FPG at the time of admission are not reliable measures to establish the diagnosis of diabetes in cases of AMI and thus follow up measurements after a period of 6-8 weeks are necessary to establish the diagnosis. Awareness in general public regarding deleterious effects of DM should be promoted
Subject(s)
Humans , Male , Female , Diabetes Mellitus/diagnosis , Prospective Studies , Case-Control Studies , Blood GlucoseABSTRACT
In the present study management of protocol of 50 cases of snake bites were studied. Twelve had no signs of envenomation while 38 had features of poisoning and were treated. Most of the patients, had poor knowledge of first aid measures and great fear of snake. First aid measures were provided. The hospital treatment included use of anti snake venom. ATS, blood transfusion, steroids, intravenous fluid, and broad spectrum antibiotics. Five patients developed acute renal failure and 2 presented with acute circulatory collapse. All were managed by specific medical therapy. Neither any patient expired nor needed any surgical intervention