Low resolution susceptibility mapping in the estimation of iron content in deep grey matter of brain at 3 tesla

The objective of this study is to determine the effect of low resolution in the estimation of iron content in deep grey matter of brain using quantitative susceptibility mapping. Six females with mean age 43.16, S.D= 20, age range [23-66] and 13 males with mean age 28.92 + 8.14 were scanned with 3D SWI sequence at 3 Tesla [Trio-Seimens, Erlangen, Germany]. The caudate nucleus, red nucleus, globus pallidus, putamen, white matter, thalamus and substantia nigra of brain were drawn manually based on their anatomical locations in Signal Processing in Nuclear Magnetic Resonance [SPIN]. Magnitude and phase images of high resolution [HR] [0.5x0.5x2 mm[3]] were processed in SPIN using collapsing parameter to generate the low resolution [LR] [1x1x2 mm[3]] susceptibility mapping. Data was analyzed using paired t-test. A strong linear correlation [R[2]=0.99, p /= 0.05 at HR, R[2]=0.66, p >/= 0.05 at LR]. The slope of the above linear correlation was consistent with the equivalent susceptibility trend at low and high resolution QSM. Linear correlation between susceptibility and iron content at HR and LR has demonstrated that low resolution QSM holds the consistency of susceptibility and does not affect the estimation of iron content in deep grey matter of brain

Serum zinc level in children presenting with febrile seizures

To determine the frequency of low serum zinc level in children presenting with febrile seizures at The Children's Hospital and the Institute of Child Health [CH/ICH] Multan. This is an observational cross sectional study conducted at the Department of Pediatric Medicine, The Children's Hospital and the Institute of Child Health, Multan from September 2010 to March 2011. Children [6 months to 6 years of age] presenting with febrile seizures who satisfied inclusion and exclusion criteria were enrolled for the study. Cause of fever was determined after detailed history, physical examination and relevant investigations. Four milliliters centrifuged blood sample was preserved in acid washed test tube. Separated serum was used to measure serum zinc level by employing Randox kit on auto-analyzer in all cases. The outcome variable [serum zinc level] was recorded on a predesigned proforma. Out of 100 enrolled children, there were 66 [66%] male with male to female ratio of 1:0.52. Mean age of the children was 23.97 +/- 14.45 months. Upper respiratory tract infection was the most frequent cause of fever apparent in 24 children [24%] followed by tonsillitis 17 [17%], pneumonia 16 [16%], urinary tract infection 16 [16%], otitis media 15 [15%], and bronchiolitis 12 [12%]. Frequency of low serum zinc level was 26% in children with febrile seizures. Zinc deficiency could be a potential risk factor for febrile seizure in children

Training of non-physician practitioners to identify and refer diabetic patients

To improve the practices of non-physician practitioners on early diagnosis and referral of patients with diabetes mellitus. Study will be conducted in a peri-urban village community in Lahore, Pakistan, during 2007 - 2008. Quasi - experimental study, one group before and after design was used to document the effect of training of non-physician practitioners on improving their diabetic patient identification practices and referral to the hospital for diagnostic and treatment facilities. Fasting blood glucose test was used to identify hyperglycaemics out of those referred by the NPPs. Patient referral was increased by 48.44% after training. Identification of hyperglycaemic patients on the basis of signs and symptoms was 47% before and 48% after training and the difference between two proportions was not significant. increased number of referral showed motivation of NPPs towards the task however more prolonged and structured training program is required to utilize their services in community as part of our health care delivery system

Comparison of diagnostic accuracy of non-invasive tests for helicobacter pylori infection in children

To compare urea breath and stool antigen in children, with hisotological diagnosis for helicobacter pylori [H.pylori] infection. Cross-sectional study. From June 2005 to December 2005 carried out at KRL Hospital, Islamabad and Children Hospital, PIMS, Islamabad. Children between 3 and 15 years of age reporting in pediatric outpatient department with upper gastrointestinal symptoms were included. All the participating children underwent an upper gastrointestinal endoscopy and 3 tests namely: histopathological identification of H.pylori [the traditional gold standard], urea breath test and stool antigen test were carried out on each child. The sensitivity, specificity, and positive predictive values were calculated for each noninvasive test used in the study. A total of 54 patients completed the study with a mean age of 8.2 years. On histological examination, 725 [39] were positive for H.pylori infection. On gross endoscopic examination, only 9 patients had signs of gastritis as compared to 39 histological positives. The sensitivity, specificity and positive predictive value of stool antigen test were: 77%, 73% and 89% respectively whereas the same for urea breath test: 79%, 80% and 91% respectively. Both the noninvasive tests were found to be sensitive and specific as compared with histological identification, for the diagnosis of H.pylori in our pediatric population. The accuracy of urea breath test was better than the stool antigen test but later was easier to perform and could fulfill the criteria for a rapid bedside diagnostic test

Pure red cell aplasia-a single centre experience

To determine the frequency of Pure Red Cell Aplasia [PRCA] in patients referred to Haematology Department of Holy Family Hospital, Rawalpindi for bone marrow examination. Single center descriptive study. The study was conducted at the Haematology Department of Holy Family Hospital Rawalpindi from 1st January 1999 to 31[st] September 2004. All patients referred to this department for bone marrow were included in this study. They comprised both male and female subjects of all ages. After taking a detailed history and conducting a complete physical examination blood samples were taken for complete blood picture. Bone marrow aspiration was done on all patients and trephine biopsies were taken only where indicated. Total of 1724 bone marrow aspirations biopsies were performed during this period, of which. 13 [0.75%] were diagnosed as Pure Red Cell Aplasia. 08/13 [61.5%] were males and 05/13 [38.4%] were females. The age range was from 1-52 years. Maximum number of patients belonged to 15-30 years age group. 01/13 [7.7%] was diagnosed as Diamond Blackfan Anaemia CDBA[2], 03/13 [23%] were associated with viral hepatitis. 04/13 [30.7%] cases had developed after some viral infection other than viral hepatitis. 01/13 [7.7%] had immune mediated PRCA, developing during the course of DAT positive hemolytic anaemia. 04/13 [30.7%] were idiopathic in origin. DBA patients initially responded well to corticosteroids but later developed resistance to steroids and became transfusion dependent. 02/13 [15.4%] patients also showed a good initial response to corticosteroid therapy and thus were labelled as Acute PRCA. 02/13 [15.4%] recovered spontaneously after diagnosis. Both these cases were children and thus diagnosed as cases of Transient Erythroblastopenia of Childhood [TEC]. PRCA is a rare disorder with a frequency of 0.75%. It is most commonly encountered in young adults secondary to a viral infection. Hepatitis is a major health hazard in our society and may play a significant role in the etiology of PRCA our patients

Bacterial pneumonias in seriously injured, hospitalized patients-an autopsy study

Bacterial pneumonias are responsibe for a high proportion of treatment illness and can lead to serious and fatal infections in debilitated and hospitalized patients. This study was carried out on unselected medicolegal autopsies to look for the occurrence of pneumonia in the hospitalized patients, and anatomical types of pneumonia were studied

Endodermal sinus tumour of the ovary

Endodermal sinus tumour of the ovary is a highly malignant germ cell cell tumour showing selective overgrowth of yolk sac endoderm intimately associated with extra-embryonic mesoblast

autopsy study of emphysema in urban and rural populations

A total of 100 human autopsies on adults of both sexes from urban and rural population of Lahore District were carried out to find the incidence of emphysema and its types. Emphysema was found slightly more prevalent in the urban than the rural population and all forms of emphysema were more common in the cases from urban areas