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Background: Crimean Congo hemorrhagic fever virus is a fatal infection that has a very high case fatality rate. It is highly infectious and there is no recommended treatment for it. Oral ribavirin is the most commonly used drug and has variety of side effect profile
Objective: To determine the frequency of side effects in cases taking oral ribavirin for post Crimean Congo virus exposure prophylaxis
Methodology: This cross sectional study study was conducted at Medical and Emergency Department, Sheikh Zayed Hospital, Rahim Yar khan from 1 January to 31 December 2016 on suspected cases of Crimean Congo Hemorrhagic Fever [CCHF] virus exposure. The cases were suspected on this basis of signs and symptoms of hemorrhagic fever and negative Dengue serology. Oral Ribavirin was given in 2 grams [gm] loading dose, 4 gm/ day for 4 days and then 2 gm/ day for next 6 days in divided doses. The cases were then followed for development of nausea/ vomiting, anemia, jaundice, generalized aches and pains and insomnia. The results were collected and recorded and analyzed by using SPSS version 22
Results: In this study, there were total 32 cases that were started on ribavirin prophylaxis. Two cases quit prophylaxis early. Out of total 30 cases left that completed the prophylaxis, 17 [56.67%] were males and 13 [43.33%] females. The mean age and weight were 32.86 +/- 7.05 years and 45.66 +/- 7.74 kg respectively. Side effect profiles were seen in 24 [80%] cases. The most common side effect was nausea/vomiting seen in 18 [60%] cases, generalized aches and pains in 17 [56.67%], anemia in 12 [40%] cases, jaundice in 11 [36.67%] and insomnia in 4 [13.33%] cases. There was no significant difference of side effects in terms of age, gender, and weight group with p values of 0.63, 0.49, and 0.25 respectively
Conclusion: Oral ribavirin is commonly used for CCHF virus exposure prophylaxis and has a very high side effect profile among which GI side effect and generalized aches and pains are the most common
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Background: Ischemic heart disease especially inferior wall myocardial infarction [IWMI] is an important health issue. It can further add to morbidity and mortality when it is associated with right ventricular [RV] infarction
Objective: To determine the frequency of right ventricular infarction in cases with acute inferior wall myocardial infarction
Methodology: This cross sectional study was conducted at Department of Cardiology, Sheikh Zayed Hospital, Rahim Yar Khan in January to 31 December 2015. The cases with age range of 30 to 80 years of IWMI; assessed by ST segment elevation of at least half mm in lead II. III and aVF, were included in this study. The co-morbidities in the form of DM, HTN, smoking, family history of IHD and dyslipidemia were also considered. However, the cases with renal failure, trauma, electrolyte imbalance and MI other than inferior wall were excluded from the study. The diagnosis of RV infarct was made by the elevation of at least 1 mm in V4R lead in cases with IWMI changes. These cases were followed during their hospital stay to look for development of any complication. The data was entered and analyzed by using SPSS version 21
Results: In this study, there were 30 cases of IWMI. Out of which 22 were males and 8 females. The mean age was 48.87 +/- 11 years. Nineteen [63.33%] cases has door to needle time less than 30 minutes. DM, HTN, smoking, family history of IHD and dyslipidemia were seen in 10 [33.33%], 9 [30%], 13 [43.33%], 01 [3.33%] and 2 [6.67%] cases respectively. Thrombolysis was done in 23 [73.33%] cases. RVinfarct was seen in 11 [36.67%] cases. RVinfarct was seen in 7 out of 22 males while it was seen in 4 out of 8 females [p= 0.36]. There was no significant association of RV infarct with any age group [p=0.60]. There was again no significant association with door to needle time, duration of symptoms, thrombolysis status and any of the risk factors with RV infarct. The most common in hospital complication was different types of arrhythmia which rd were found in 9 [30%] cases
Conclusion: Inferior wall MI is reported in good number of cases. Every 3 case of inferior wall MI also has right ventricular MI
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Background: Acute coronary syndrome [ACS] is an acute emergency. It covers a wide spectrum of symptoms ranging from anginal pain to life threatening emergencies of myocardial infarctions. ACS can end up in various complications
Objective: To determine the patterns of acute coronary syndrome, in cases presenting to chest pain unit of Sheikh Zayed Hospital, Rahim Yar Khan
Methodology: This cross sectional study was carried out at chest pain unit at [CPU], Emergency Department, Sheikh Zayed Hospital, Rahim Yar Khan from 15[th] January to 16th July 2015. The cases with age range of 30 to 80 years with typical chest pain and ECG changes were included. The case with end stage renal failure, electrolyte imbalance, trauma, and documented cases of IHD were excluded from the study. The cases with ST segment elevation were labeled as STEMI while with ST-T changes with raised cardiac enzymes as NSTEMI and normal enzymes as unstable angina. They were also assessed for in hospital complications. The data was entered and analyzed by SPSS version 22
Results: In this study there were 50 cases, out of which 33 [66%] were males and 17 [34%] females. The mean age was 49+/- 10 years. STEMI was seen in 35 [70%] cases followed by NSTEMI in 9 [18%] and UA in 6 [12%] cases. All the components of ACS were more common in males as compared to females with [P= 0.76]. The most cases of ACS were seen in age groups of 41 to 49 years [p=0.54]. There was no significant association of any of the risk factors with any type of ACS. Recurrent angina and arrhythmia were the two most common complications
Conclusion: ACS is well-reported entity and STEMI is the most common subtype found, at chest pain unit
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Objective: to assess the pattern, causes and frequency of Complication of Ventriculoperitoneal Shunt surgery in Paediatric patients
Material and Method: 404 patients with hydrocephalus were operated between the period of 2004 to 2013 in the Departments of Neurosurgery and Paediatric Surgery at Allied Hospital, Punjab Medical College, Faisalabad. All patients with provisional diagnosis of Hydrocephalus were admitted in the hospital, detailed history was recorded and general physical examination with special emphases on neurological examination. Diagnosis was confirmed on the basis of investigations like Cranial Ultrasonography, CT and MRI scanning. Data analysis was carried using Statistical package of social Sciences [SPSS]
Results: of the 404 patients 176[81.48%] were male and 40[18.51%] female. Shunt infection was the commonest complication [12.9%] followed by Blockage [8.3%]. Shunt related mortality was [1.8%]. The mean age among the patients showing disconnection was 20.7 months compared to mean age of 7.8 months for not having this complication[p<0.04]
Conclusion: infection remains the most significant complication of VP Shunt surgery. Ventriculoperitoneal Shunt operation should be considered a major surgical procedure. Children with VP shunt should receive follow-up through the transition the adult hood
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Objective: surgical outcome of tethered cord syndrome
Study Design: retrospective descriptive
Period and Place of study: Neurosurgery Department Allied Hospital Faisalabad over 6 months from October 1, 2014 to March 28, 2015
Materials and Methods: forty patients were selected at Neurosurgical Department, Allied Hospital, Faisalabad with age ranging from 2 months to 27 years[average 2.58 years]. These were assessed clinically and their orthopedic and urological aspects were also assessed. MRI of relevant area was advised. Counselling was done regarding surgery under general anesthesia and its outcome. Laminectomy or laminotomy was done. Cord was detethered from its attachments from dura, and, in case of lipomeningocele, from its extradural component. In case of diastometomyelia, bony spur was extirpated and dura- plasty was done. Tight filum terminale was divided. Surgery was done using microsurgery techniques. Postoperative assessment was done immediately at the time of discharge, at 6 and 12 months
Results: a total of 40 patients, M:F ratio was5:3. Average age was 2.58 years.Age was ranging from 2 months to 27 years. Power improved in 44 % to grade 5/5 and 37% in grade 4/5 at one year. There was 65 % improvement in anal sphincters and 71% improvement in urinary sphincters at one year
Conclusion: our clinical and neurological evaluation showed satisfactory outcome after surgery, particularly when performed before the onset of irreversible deficit. Neurological status prior to surgery has profound impact on the outcome
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To determine the validity of Siriraj Stroke Score in differentiation between intracerebral and cerebral infarction. Hundred patients of stroke admitted in Medical Unit-Il Sheikh Zayed Hospital, Rahim Yar Khan were selected. CT scan brain was done in all patients with clinical application of siriraj score and results were compared. Duration was one year from January 2008 to December 2008. The brain CT scans of 100 patients referred with clinical diagnosis of stroke were reviewed. Of the 100 patients with stroke and complete clinical records, 67 were males and 33 were females. The age of the patients ranged from 21 to .9 years with a mean of 60 +/- 4.3 years. Twenty six [26%] patients were comatose, on presentation and history from the relations was relied upon. Fifty-six [56%] patients had CT scan features of cerebral infarction, whilst 44 [44%] patients had features consistent with the diagnosis of intracerebral hemorrhage. Using the Siriraj stroke score, 92 [92%] patients were classified, 52 [52%] as cerebral infarction and 40 [40%] as intracerebral hemorrhage. Eight [8%] patients had indeterminate scores. It is unlikely that any score will replace brain imaging. So, until unless result of such a study is available, we contend that computed tomography scan should remain the only reliable investigation for distinguishing between intracerebral hemorrhage and cerebral infarction among Pakistanis and it should be made available and affordable
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Humanos , Masculino , Femenino , Hemorragia Cerebral , Infarto CerebralRESUMEN
To determine frequency of hypoglycemia in non-diabetic patients undergoing hemodialysis. Fifty non-diabetic patients were studied during hemodialysis for hypoglycemia for period of six months from January 2009 to June 2006 in the Department of Medicine, Sheikh Zayed Hospital, Rahim Yar Khan. Out of 50 non-diabetic patients, 9 patients developed hypoglycemia dueing hemodialysis in the study mostly were in old age above 55 years and were on maintenance dialysis. hypoglycemia should be considered as a complication during hemodialysis and blood sugar should be checked, if any sudden change in patient is observed during hemolysis
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Humanos , Masculino , Femenino , Hipoglucemia/etiología , Hipoglucemia/epidemiología , Fallo Renal CrónicoRESUMEN
To determine prevalence of hepatitis-B and C among patients of CKD on hemodialysis in Sheikh Zayed hospital Rahim Yar khan and assess screening methodology for hepatitis-B and C before hemodialysis in this tertiary care hospital. This descriptive study conducted at the hemodialysis section of Sheikh Zayed Hospital, Rahim Yar Khan from January 2008 to December 2008. All the patients of chronic renal failure who were admitted in medical ward either from OPD, Emergency or from private clinic of consultants they were all screened for hepatitis-B and C by kit method using technique after getting consent for testing during 2008. A total of 190 patients were screened, all patients were re-evaluated for hepatitis-B and C detection on three months basis along with liver enzymes. Among 190 patients 82.6% belongs to RYK while only 17.4% are from other areas. Out of 190 patients 127 were males and 63 were females. And 45% were between the age of 30 to 50 years. 25% were above 50 years of age while 27% were below 30 years. Only one patient was above 80 year. Out of 190 patients 74.7% [142] were BC-ye. 18.9% [36] were c+ve. 5.8% [11] were B+ve. And only 0.5% [01] patient was BC+ve. Hepatitis-B and C detection should be repeated on six month interval along with liver enzyme as CRF patients are more exposed to Hepatitis-B and C. This study gives good idea about proper prevention in these patients where prognosis become more poor when CRF is superadded with B and C infections
Asunto(s)
Humanos , Fallo Renal Crónico/virología , Hepatitis C/epidemiología , Hepatitis B/epidemiología , Prevalencia , Transmisión de Enfermedad Infecciosa , Hepacivirus , Virus de la Hepatitis BRESUMEN
A high prevalence of hypertension, obesity ond cardiovascular disease in urban and immigrant Pakistanis is generally attributed to their changed lifestyle. However, no studies have reported the prevalence of these conditions in the large rural population of Pakistan, from where immigrants have often originated, and where the traditional lifestyle is still followed. We, therefore, studied the prevalence of [and factors associated with] obesity and hypertension in this population group. Age, sex, occupation, smoking status, weight, height, waist, hip circumference and blood pressure were recorded in all subjects > 25 years in this typical village of Punjab, Pakistan. Of 470 subjects, 35% smoked, twenty were hypertensive [4.3%] and 30 were sedentary [6.4%]. Nine [1.9%] had body mass index [BMI] >= 30 kg/m[2], 28 [5.9%] BMI of 25-29 kg/m[2] and 134 [28.5%] BMI<18.5 kg/m[2]. Blood pressure significantly and positively correlated with BMI, waist, hip and waist/hip ratio. Sedentary individuals were more likely to be young, obese and have higher blood pressure. Although obesity and hypertension were not common, the small number of sedentary individuals were more likely to suffer from them. These findings are relevant in prevention and management of obesity/ hypertension in urban and immigrant Pakistanis