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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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To compare the effectiveness of Misoprostol with syntocinon in the prophylaxis of primary post partum haemorrhage during the management of 3rd stage of labour. Experimental study. Department of Obstetrics and Gynaecology Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. Pregnant patient with term pregnancy in labour were admitted in labour room. After confirmation that the patient is in labour, they were randomly divided in two groups A and B with 50 patients in each group. 600 ug oral Misoprostol was given to patients in group A and 10 units I/V Syntocinon were given to patients in group B at the time of delivery of anterior shoulder of the baby. Amount of blood loss was observed and all the information were recorded and entered in predesigned proforma. Amongst the 100 pregnant patients the mean age was 28.86 + 2.94 and mean parity of patients was 3.94.57% of patients were presented with labour pains only and 27% presented with both labour pain and leaking liquor. In 59 patients duration of labour was between 2-12 hours. Total 9 patients develop PPH in both groups, three patients from Misoprostol group and six patients from syntocinon group. PPH was mild to moderate and settled down with other uterotonic drugs none of the patient required surgical intervention. Development of minor side effect was relatively high in Misoprostol group i.e. 10% such as nausea, vomiting while 4% in syntocinon group. Shivering and mild pyrexia was 12% in Misoprostol group while 5% in syntocinon group. In this study effectiveness of both syntocinon and Misoprostol has been found comparable Misoprostol being slightly more effective than syntocinon in managing 3rd stage of labour also prophylacticaly and it also has fewer minor side effects with no serious danger to life. It does not need skilled personnel for its use
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Humanos , Femenino , Adulto , Misoprostol , Resultado del TratamientoRESUMEN
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