ICD-9 pattern of diseases at Nishtar hospital, Multan

To study the pattern of diseases during last ten years in accordance to ICD-9. Design: Retrospective analysis of the record of the patients admitted in the Medical Department. Setting: Central record office [Statistical Officer's record] of the Nishtar Hospital, Multan. Material: Record of the total adult [age > 12 years] patients [100758] admitted in the Medical Department of the Nishtar Hospital, Multan during 1984-1993. Main Outcome Measures: Rearrangement of the patient's data on the pattern of International Classification of Diseases-9 [ICD-9] and ranking of diseases according to number of patients and deaths. Total 100758 patients [16.14% of total admissions] were admitted during these 10 years in the Medical Department of Nishtar Hospital, Multan. 39.69% were females and 60.31% were male patients. There were 8328 [8.265%] deaths. A progressive significant increase [p < 0.001] in number of patients and deaths during this period was noted. Patients were rearranged into 12 main groups according to ICD-9. Cardiovascular diseases were at the top [patients 24.23% deaths 23.70%] and poisoning [patients 1.29%] and connective tissue diseases [deaths 1.20%] were at the bottom. Conclusions: A significant increase in number of patients/deaths [p< 0.05 or less] was noted in cardiovascular, Nervous system, Gastrointestinal and Liver, Neoplastic, Miscellaneous diseases or poisoning. While a significant decrease [p< 0.05 or less] was noted in respiratory, nephrological, diabetes mellitus and endocrine, anemias and blood and connective tissue diseases. The pattern of diseases observed here are entirely different from USA, UK, China or Mauritius. The limitations of hospital data have also been described

Medical status of patients attending the oral diagnostic clinic at the university of Jordan

Medical status of 1546 subjects attending the oral diagnostic clinic at the dental school of the University of Jordan was examined by a structured verbal interview by the author. Significant medical histories and/or current drug therapies of relevance to the practice of dentistry were found in 21.9% and 10.1%, respectively. Medical problems identified included hypertension [6%], drug allergies [5%], diabetes mellitus [3.6%], arthritis [2.4%], heart disease [1.7%], peptic ulcer [1.3%], bronchial asthma [1.2%], neurological, disease [0.6%], thyroid disease [0.4%] and blood disorder [0.2%]. The prevalence of significant medical histories increased with increasing age and in many categories the number of females was greater than males

Myocardial infarction, geomagnetic factors and psychological status of the patients: are they related?

The analysis of 138 myocardial infarction [MI] cases has been carried out for the period of 366 days. The results were compared with prognostic and truly disturbed days when the geomagnetic pole was elevated [the data of Institute of Geophysics in Gottingen, Federal Republic of Germany were used]. Hemodynamic parameters and psychological status of the patients with MI were determined according to MMPI test. It was noted that greater number of persons fell ill when prognostic and truly disturbed days coincided. No considerable increase in MI morbidity was found only in disturbed days. Certain specific psychological profile prevailed in patients who fell ill in coincided days, disturbed days and prognostic days known and unknown to the patients. It is proposed that the human organism becomes more sensitive to the geomagnetic factors when psychological and physical deadaptation occurs. This is also reflected by the destabilization of regulatory system of the organism

Effect of different modalities of treatment on the quality of life of breast cancer patients in Egypt

The impact of breast cancer therapy on the quality of life [QL] of Egyptian women was studied. Patients were divided into four groups: 1: mastectomy alone; 2: surgery plus radiotherapy; 3: surgery plus chemotherapy; and 4: triple modality. The results revealed that all the four domains of QL of women having adjuvant therapy [groups 2, 3, or 4] were significantly altered compared to those who underwent mastectomy alone. Triple modality adversely affected global QL the most compared to radiotherapy or chemotherapy; radiotherapy had significantly less effect on QL compared to chemotherapy. Triple modality predicted the worst QL. QL measures should be incorporated with the traditional end points for evaluation of treatment and patients given health education on the effects of each therapy

Statistical analysis of some parameters of nonsteroidal anti-inflammatory drugs

The objective of the present study is to determine some statistical parameters between the dissociation constants and the solubility of the 16 NSAIDs at different pH, which belong to several chemical groups within the small class of acidic drug substance

Values of certain clinical and biochemical tests for prediction of pre-eclampsia

To evaluate different predictive tests for pre-eclampsia, either individually or in combination, we prospectively studied 100 primigravid females. Eighty-eight of the subjects continued the follow-up until delivery and 17 developed pre-eclampsia. Venous blood samples were taken for determination of plasma fibronectin, and urine samples were taken for determination of microalbuminuria and calcium-creatinine ratio. Isometric handgrip exercise tests were also performed. Evaluation of predictive tests, as well as t and chi-squared statistical tests, were used for analysis of data. Pre-eclampsia developed in 19.3% of the patients studied. Pre-eclamptic and normotensive females showed significant differences in calcium-creatinine ratio and plasma fibronectin levels in both [14-24 weeks and 28-32 weeks] gestation periods [P<.0001]. Plasma fibronectin had the best sensitivity, positive, and negative values in gestation period 14-24 weeks, whereas isometric handgrip exercise tests had the best specificity. These values improved for all the tests in the 28-32-week gestation period; even so, plasma fibronectin proved best of all. A combination of tests failed to improve the predictive ability of fibronectin alone. We conclude that plasma fibronectin is the best predictive test for pre-eclampsia

Treatment of post withdrawal depressive symptoms in detoxified heroin addicts with fluoxetine and naltrexone maintenance

Depression is a common phenomenon which might lead to early relapse in the first few weeks after opiate detoxification. There is strong evidence that depression is related to the central nervous serotonin system. To prove the hypothesis of the impact of serotonin in depressive detoxified addicts, a selective serotonin re-uptake inhibitor in the after care was used. In a prospective, open clinical trial, forty detoxified opiate addict males were randomly assigned to two groups receiving either 50mg naltrexone alone or with fluoxetine 20mg. After 30 days, the depression score was significantly lower in the floxetine group, but the incidence of continued opiate intake remained higher in this group. However, the additional naloxone provocation test did not lead to withdrawal signs, proving the naltrexone maintenance

influence of wearing dentures on the masticatory performance

Twenty male patients having two m and ibular canines were selected and an overdenture, an interim tooth-attached denture and a complete denture were constructed for each patient in this study. Clinical measurements of the activity of masticatory muscles, bite force strength and chewing efficiency were performed immediately at the time of denture insertion and six months after wearing the tested dentures. Comparing the results of the three types of the tested dentures indicated that there were increases in masticatory performance after six months of wearing the different dentures. The highest value of masticatory performance was in the overdenture and the lowest value was in the conventional complete dentures and interim tooth attached denture had intermediate value

Regression of hypertrophy after aortic valve replacement for chronic aortic regurgitation

Factors influencing magnitude of regression of left ventricular hypertrophy after successful aortic valve replacement have been studied in 20 patients with chronic aortic regurgitation by cardiac catheterization, echocardiography and left ventricular muscle biopsy. Patients with preoperative value of left ventricular end diastolic pressure >20 mmHg and/or left ventricular end systolic dimension >5.6 cm are less likely to have normalization of their left ventricular mass index following aortic valve replacement. Preoperative left ventricular mass index does not predict changes following aortic valve replacement. Increased amounts of interstitial fibrosis appear to be related to incomplete regression of left ventricular hypertrophy after aortic valve replacement

Effects of tiaprofenic acid and piroxicam on serum and 24 hour urinary excretion of calcium in normal and adjuvant-induced arthritic rats

This study was performed in conscious male albino normal rats to determine the changes in Ca+2 excretion and its concentration in the serum following oral administration of prostaglandin synthesis inhibition by tiaprofenic acid [10 mg/kg] and piroxicam [1 mg/kg] for 21 days. It was found that tiaprofenic acid reduced the mean +/- SE 24-hour urinary Ca+2 excretion significantly after 10 and 21 days. This reduction did not reverse after one month from stoppage of its administration. Serum Ca+2 was lowered significantly after 21 days from its administration and persisted after one month from withdrawal of the drug. Piroxicam reduced significantly Ca+2 excretion and serum concentration of Ca+2 after 10 days and more reduction appeared after 21 days from administration. This reduction was not reversed after one month from stoppage of its administration. On the other hand, in arthritic rats, tiaprofenic acid reduced significantly urinary Ca+2 excretion and serum Ca+2 after 10 days from its administration and more reduction was observed after 21 days. As regads arthritic rats receiving piroxicam, it was found that 24-hour urine volume, urinary excretion of Ca+2 concentration were decreased significantly after 10 days from its administration. This reduction became more apparent after 21 days. One month after withdrawal of tiaprofenic acid and piroxicam, some improvement in these parameters was observed but still a significant reduction was noted compared with the control group [arthritic rats]

Ethical issues in medical statistics

Medical statistics [biostatistics], as a vital essential part of modem life, does raise some fundamental ethical issues. Surprisingly, this aspect seems to have been totally ignored by books on medical ethics. This paper discusses how the statistical aspects affect the ethics. The relation between biostatistics and medical research is explored. All stages of a medical research exercise are vulnerable to statistical mismanagement which might lead to misuse of patients by exposing them to unjustified risk and inconvenience; the misuse of resources including the researchers' time, which could be better employed on more valuable activities; and the consequences of publishing misleading results, which may include carrying out unnecessary further work. These are specific and highly undesirable outcomes. Failure to guard against these is surely as unethical as using experimental methods that offend against moral principles, such as failing to obtain full informed consent from subjects. Raising statistical standards of medical researches and publications serves as a safeguard to observe the element of ethics. This can be achieved by widespread teaching of medical statistics at all levels, involvement of biostatisticians as active participants of any medical researches and ethical committees. Ethical issues in medical statistics require wider and more open debate. Those involved in medical research need to involve the whole medical profession. Indeed, moral philosophers, theologians, and other professional groups have an important contribution to make

Analysis of 1612 patients admitted to the burn unit in Salmaniya medical centre, Bahrain, from 1984-1991

This retrospective review of burn cases admitted to the Burn Unit at SMC from 1984 to 1991 demonstrated that 50% of these cases are in the paediatric age group, and that the young labourers constitute a significant proportion of the burn victims. We believe launching an effective public education campaign coupled with strict laws will lead to a decrease in the incidence of this very costly tragic illness

Determinants of birth weight, a study of selected maternal variables

Case records of 216 mothers were analysed retrospectively to study the influence of prepregnancy weight, maternal height, haemoglobin, age and parity, and period of gestation on birth weight. Prepregnancy weight, maternal height and period of gestation were found to be significantly correlated with birth weight. The fitted regression model explained 29.88% of the total variation in birth weight with R2 for period of gestation being 14.37%, and R2 change being 11.85% and 3.66% when maternal weight and height were added respectively in the stepwise multiple linear regression analysis