Detection of osteoporosis by dual energy X-ray absorptiometry

An early detection of osteoporosis through DEXA procedure will not only improve the disease management practices but also would help in impeding national productivity losses by mass screening and awareness. Our objective was to measure efficacy of DEXA procedure in early detection of osteoporosis and prevention of its complications. This case series observational study was designed to confirm the bone mineral density by dual energy x-ray absorptiometery [DEXA]. The duration of study was three years from November 2010 to October 2013. Subjects aged between 30 [when the risk of osteoporosis is low] to 60 [when osteoporosis is almost sure to be found]. Three hundred thirty patients were evaluated. There were 23 [6.96%] male and 307 [93.03%] female. Normal male were 09 [39.10%], osteopenia 11 [47.80%] and osteoporosis 3 [13%]. Normal females were 72 [23.50%], osteopenia 140 [45.60%] and osteoporosis 95 [30.90%]. P-value was more then 0.005 and not significant. Mean age was 48.73, minimum 30, maximum 60 and SD 7.247. Population category distribution was 243 [76.6%] from urban and 87 [26.4%] rural. In urban areas normal were 56 [23%], osteopenia 113 [46.50%] and osteoporosis 74 [30.50%]. In rural areas normal 25 [28.70%], osteopenia 38 [43.70%] and osteoporosis 24 [27.60%]. P-value was 0.567. Out of 330 there were 81 [24.54%] normal, 98 [29.69%] osteoporosis and 151 [45.75%] osteopenia. Osteopenia was the most common diagnosis mostly in younger age group and early diagnosis of this problem can help prevent osteoporosis

Diabetic patients; awareness about life style modifications

To assess awareness about the role of lifestyle changes in the management of diabetes among diabetics. Diabetic clinics of Jinnah Postgraduate Medical Centre and Kidney Centre. Karachi. From April 7, 2008 to August 31, 2008. Cross Sectional. Convenient. Sample Size: 200 diabetic patients. A total of 200 diabetics were interviewed. Their mean age was 48.8 years. Of these 92 [46%] were males and 108 [54%] were females. Diabetes was under control of 38% and 57% were taking regular treatment. Education sessions were attended by only 11%, counseling for lifestyle modification was done with 16%, 30% followed diet chart and 18% of the study participants were doing regular / irregular exercise. Majority of them [68%] needed social and family support to cop up the disease. There was a lack of awareness about the role of lifestyle changes in the management of diabetes among these diabetic patients. There is a need of health education programs for diabetics and general public

Medications used by the patients with chest pain before reporting to the emergency room at national institute of cardio-vascular disease, Karachi, Pakistan

Objectives: To document the medicines taken by patients, with chest pain reporting to the cardiac emergency room, and to determine the role of patients and health care providers to deal with cardiac emergency

Patients and methods: This cross-sectional study was conducted at National Institute of Cardiovascular Disease [NICVD] Karachi from June 01 to September 2007. Patients with chest pain were taken detailed history and were especially asked for the medicines taken by them prior to presenting at NICVD after which they were treated as per routine. A predesigned proforma was used to record the data

Results: The study subjects had a male ratio of 64:36, from various occupations and socio-economic strata. The patients who came by ambulance were 100 [15%], and the medications were used by only 152 [22.9%]. This was the first visit to cardiac emergency of 403 [60.8%] patients. One hundred fifty-three [23%] patients were referred, 67 [10.1%] transferred, and 443 [66.8%] came directly because of their symptoms. 283 [42.7%] patients had visited another doctor before coming to NICVD

Conclusion: The number of male patients with chest pain reporting to cardiac emergency was more; a vast majority did not have access to ambulance and did not take emergency measures. In majority of cases, other health care providers did not advise to take some medicine in emergency

Problems faced by the nurses during duty hours

To find out the job related problems faced by nurses during duty hours and to know their effects on their personal life, behavior with colleagues, senior nurses, administrators and patients. A Cross sectional study. Allied Hospital Faisalabad, a tertiary care health Institution attached with Punjab Medical College [PMC] Faisalabad. From 1[st] May to 30[th] June 2007. The study was conducted among the charge nurses and student nurses working in Allied Hospital Faisalabad. Data were collected by convenient sampling of 100 nurses, through structured questionnaire which were tabulated and analyzed. A total of 100 nurses participated, out of which 34% were charge nurses and 66% were student nurses. Needle prick injury was the most common accidental hazard among student nurses [48%] and charge nurses [35%], as the P. value was 0.189 so there was no significance difference/association between the two groups of nurses. Musculo-skeletal Problems were commonly found among [23%] charge nurses whereas [15%] student nurses also experienced musculo-skeletal pains during duty hours, as the P. value was 0.189 so there was no significance difference/association between the two groups of nurses related to Musculoskeletal Problems. Regarding problems due to work overload, irritability [35%], sleep disturbances [18%], emotional instability [35%], and mental stress [35%] were found among charge nurses whereas headache [33%], mental stress [27%] and emotional instability [33%] were reported in student nurses. Latex allergy was found among [36%] of charge nurses while [18%] student nurses also reported the same problem due to use of rubber gloves, Twenty-two [33%] student nurses had lack of support from seniors and [39%] students reported difficulty in communication with physicians and senior nursing administrators, whereas [35%] among charge nurses had communication problems with their seniors. As the P value was 0.659, so there was no significance difference / association between the two groups of nurses regarding support from seniors and communication. Needle prick injury was more common among student nurses whereas problems due to work overload were found in majority of charge nurses. Day to day problems faced by the nurses during duty hours could be reduced or prevented through the appropriate measures by concerned authorities

Histamine receptors; responses and modulations towards agonist and antagonist on the rabbit ileum, in vitro study

This research work deals with the mechanism of action involved in determining the therapeutic potential of histamine and its blockers in gastrointestinal motility. Rabbits of equal weights were used in this study. They were brought from the animal house of BMSI, sacrificed in the Pharmacology Research laboratory. lleum strip were isolated and with special recommended methodology, longitudinal and circular muscles were separated. Individual muscle strip were then exposed separately to the desired drugs in the organ bath and reading were recorded on the polygraph machine. Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi. 1996 to 1998. Histamine increases the contractile effects of longitudinal and circular muscle. H[1] and H[2] blockers potentiate its effects on longitudinal muscle while in circular muscle no change was observed with H[1] blocker whereas H[2] blocker antagonized the histaminic effects. However when H[1] blocker applied directly it increases the amplitude of contraction in longitudinal and circular muscle whereas H[2] blocker decreases the height of contractions. Histamine in the presence of H[1] and H[2] blocker augmented their effects in longitudinal muscle and antagonizes in circular layer. Gastrointestinal motility can be controlled through histamine and its antagonist. New drugs can be formulated on the basis of this study for the regulation of intestinal motility

Sublingual dermoid cyst

A case of 22 years old male with a sub lingual swelling causing discomfort in deglutition and speech is reported. The pathology was diagnosed as sub lingual dermoid cyst. It was completely excised from an oral approach. Later, the normal functions of tongue were restored without any residual complaint

Giant cell tumours of the maxilla and tibia presenting concurrently as an initial manifestation of primary parathyroid adenoma

A 14 years female of Afghan origin reported with maxillofacial and tibia growths causing progressive deformities since nine months, both were giant cell tumours on histopathology. Serum calcium was normal, but the parathyroid hormone was exaggerated [678pg/ml]. Ultrasound indicated and Tc-99m Setamibi scan confirmed a left lower parathyroid lesion. A 4cm length mass was identified, removed and proved to be a parathyroid adenoma. Two weeks later a subtotal maxillectomy and six weeks later anterior wedge osteotomy of the tibia were carried out. Serum parathyroid hormone level normalized

Therapeutic effects of honey versus silver sulphadiazine in the management of burn injuries

To determine the therapeutic effects of honey versus silver sulphadiazine 1% in the management of burn injuries, in our set up. A quasi-experimental study. Burns emergency unit, department of Plastic Surgery Liaquat University Hospital, Hyderabad - Sindh form January 2002 to December 2003. Eighty patients having age range of 4 to 62 years with burn involving 10% to 40% body surface area were studied. Patients presenting with chemical or electric burn, and those with full thickness burn were excluded. Majority of cases was males. Patients were divided in two groups. One group received treatment with honey while other received silver sulphadiazine. Honey used was natural and unprocessed. Patients treated with honey showed rapid wound healing with no apparent local or systemic side effects. Mean duration of healing in honey treated group was 15.3 days. While in other group, mean was 20 days. Patients treated with honey did not develop growth of any pathogenic organism. However, 32[80%] patients treated with silver sulphadiazine showed growth of different pathogenic organisms necessitating the use of systemic antibiotic therapy accordingly. In honey group, only 3[7.5%] patients developed contracture as compared to 7[17.5%] patients treated with silver sulphadiazine. After complete healing, itching/pruritus was complained by 13[32.5%] patients treated with silver sulphadiazine while only 2[5%] patients complained so treated with honey. The burn wounds are healed rapidly by using honey with minimum scarring and pigmentation as compared to silver sulphadiazine. Use of honey in these patients can be cost effective in terms of treatment and hospital stay. However, to develop more confidence with the use of honey in burn wound management, more studies with larger sample size are needed

Knowledge and attitudes of medical students to people with HIV and AIDS

This cross-sectional study among 244 medical students of fourth and fifth year was done over a period of two months from November 1994 to December 1994 to assess the knowledge and attitudes of medical students towards HIV/AIDS. We administered a multiple choice questionnaire pertaining to factual knowledge and attitudes of medical students towards HIV/AIDS patients. The respondents were asked to mark the correct choice [true] in boxes opposite the statements. About the cause of AIDS 96.7% responses were correct. Knowledge about transmission by blood transfusion and sexual contact was correct in 87.7% and 96.3% respectively, but mother to child transmission was known to 77% medical students. 25% respondents had a misconception that these patients should not be allowed to use common toilets and doctors and nurses should attend these patients only after wearing a special dress. HIV antibody test for diagnosis was known to 72.1%. Knowledge about counseling to family members of HIV infected persons to avoid blood and body secretions, sexual act, condom use and to continue normal schooling was found correct in 85%. We conclude that knowledge concerning etiology, epidemiology and major modes of infection was found satisfactory in medical students of our institution. However, knowledge about mother to child transmission and inability of viral transmission by casual social contact was relatively inadequate