Role of zinc supplementation in acute diarrhea in pre-school children

Objective: To monitor the therapeutic impact of zinc supplementation on clinical course of acute diarrhea i.e. frequency of stool, on stool amount and duration of acute diarrhea

Study Design: Randomized controlled trial

Place and Duration of Study: Family medicine department, PAF Hospital, Islamabad Pakistan from Jul to Dec 2009

Material and Methods: One hundred and twenty eight children aged6 months to 60 months in an Outpatient pediatric department of PAF Hospital, E-9 Sector Islamabad with acute diarrhea of less than 14 days were included in this randomized controlled trial. They were further divided into two groups zinc supplemented group [n=65] and non-zinc supplemented group [n=65]

Results: Baseline characteristics were similar in both the groups. Mean age in zinc supplemented group was 33.67 +/- 16.45 months and in non-zinc supplemented group 33.63 +/- 16.44 months. Reduction in stool frequency per day was found 62% in zinc supplemented group and 26% reduction was found in non-zinc supplemented group with obvious difference of 36% between these two groups from day 3 to day 5, which was found statistically significant [p=0.01]. Similarly, significant difference [p=0.01] was observed for reduction in amount of stool per day from day 3 and day 5 with obvious difference of 45% between the study groups

Conclusions: Oral zinc administration in acute diarrhea reduces the frequency of diarrhea, output of stool and decreases total duration of diarrhea

Effects of deltamethrin treated uniform on malaria prophylaxis in troops of Bahawalpur garrison

Objective: To determine the efficacy of deltamethrin treated uniforms on repellant action against mosquitos in serving soldiers

Study Design: Randomized control trial

Place and Duration of Study: Bahawalpur Garrison, from 18 Aug to 24 Aug 2014

Patient and Methods: Two groups were selected for the study, one group comprising of 100 x soldiers wearing deltamethrin treated uniforms and other group comprising 100 x soldiers wearing non-treated [normal working] uniforms-control group. All soldiers were males, their age ranged from 20 years to 41 year. Uniforms were issued centrally with no group knowing which group has been issued treated uniforms, [double blind study was carried out to eliminate subject bias]. Coding system was evolved while issuing the uniforms which were only known to the main researchers, president of the study board. Both the groups were made to sit for one hour in a large training ground of the formation in two separate groups at a distance of 50-60 feet between the groups and 10-15 feet between the individuals. All the individuals were asked to count the number of mosquitos attracted towards them, whether sitting/biting on their uniforms or on their bodies. Mosquito counting was also facilitated by the organizing/conducting staff. The study continued for a week from 18-24 Aug 2014. All soldiers were given 2 x tabs Chloroquine stat as prophylaxis for malaria prior to the study. Mean and SD of no of bites of both groups were compared and analyzed. Student t-test was applied to note the statistical significance among the study groups

Results: Out of the two groups the individuals wearing deltamethrin treated uniforms showed about overall 90% protection from mosquitos as compared to the control group. The average number of bites by mosquitoes in the control group was 7/person in one hour, whereas it was less than one bite/person in the case group

Conclusion: This study confirmed that the deltamethrin treated uniform is highly effective in having mosquito repellant action in the field and may be used during operational/training duties in the field so as to better protect the troops against this health hazard

Features of retinopathy of prematurity in a tertiary care hospital in Lahore

To study the demographic and clinical features of Retinopathy of Prematurity in urban Punjab. The cross-sectional study was performed at Hameed Latif Hospital, Lahore, from April 2010 to October 2013 and comprised neonates born with birth weight less than 2000g, gestational age less than 37 weeks, or those who were considered high risk for Retinopathy of Prematurity. Variables recorded included history, birth weight, gestational age, oxygen supplementation, development of Retinopathy of Prematurity, and laser treatment. Data was analysed using SPSS 17. There were 285 neonates in the study with a mean birth weight of 1280.34 +/- 350.43g and mean gestational age being 29.38 +/- 3.14 weeks. Overall, 167[58.6%] received supplemental oxygen, 86[30.2%] were anaemic and 44[15.4%] received blood transfusion. Besides, 47[16.5%] premature babies were product of multiple gestation, 34[11.9%] were having respiratory distress, 25[8.8%] had sepsis and received intravenous antibiotics, 70[24.6%] developed Retinopathy of Prematurity, and 22[7.7%] developed threshold disease and received laser treatment at mean gestational age of 32.11 +/- 2.53 weeks. Screening is key to preventing childhood blindness caused by Retinopathy of Prematurity. Prematurity, low birth weight and supplemental oxygen therapy are significant risk factors for the condition

Comparison of three port and two port technique of silicone oil removal

Objective: this study was conducted to see whether the three port or two port technique is better to remove the silicone oil in patients who have undergone pars plana vitrectomy and silicone oil injection for the treatment of retinal detachment more than three months ago

Study Design: it was a prospective interventional study

Place and Period of study: conducted in Ophthalmology Departments of Mayo Hospital, KEMU Lahore and Allied Hospital, Punjab Medical College Faisalabad from July 2012 to July 2014

Materials and Methods: total fifty patients were included in this study, aging from 19 to 71 years with an average of 43.71 years. They had undergone pars plana vitrectomy with silicone oil endotamponade, more than three months ago. Prophylactic 360degree laser had been applied to all these cases. These patients were divided into two main groups, A and B, each group comprising of twenty five patients. In group A silicone oil was removed by using three port technique and in group B by two port technique. All patients were examined on the first postoperative day and then after one month. The final best corrected visual acuity was checked postoperatively by Snellen's chart one month after silicone oil removal

Results: on first postoperative day, in group A all patients had attached retina, no silicone oil bubble seen in vitreous cavity while there were few microdroplets of silicone oil. After one month best corrected visual acuity [BCVA] of operated side was on average 0.17, from minimum 0.03 to maximum 0.33. In group B all patients had attached retina, slightly more microdroplets of silicone oil in the vitreous cavity. Two patients [8%] had a part of silicone oil remaining behind in the vitreous cavity. So we had to operate again these patients to remove the last bubble of silicone oil. After one month BCVA of operated side was on average 0.12, from minimum 0.05 to maximum 0.25

Conclusion: the three port technique of silicone oil removal looks to be a better one. The ultimate best corrected visual acuity was slightly better with this technique and there were few microdroplets of silicone oil in vitreous cavity as compared with two port technique

Risk factors; comparison in hepatitis B and C carrier pregnant women and healthy pregnant women

To determine the risk factors associated with hepatitis B and C carriers versus healthy pregnant women. It was a single center based, cross sectional comparative study, conducted at Gynae ward II, B-V hospital Bahawalpur. Duration of study was from March to August 2008. 100 patients were enrolled in the two groups, 50 HbsAg/Anti HCV positive women [cases] to compare with 50 healthy women [controls] match for parity. The data were recorded on a proforma. 100 pregnant women were enrolled. Sixty eight [68.0%] were aged 25 years or less with a mean age +/- S.D of 24.62 +/- 3.40. Ten [20%] women had HBV and 40[80%] were HCV positive. The risk factors were compared between the two groups by uni-variate and multivariate analysis which showed that history of dental treatment, blood transfusion, surgery, parenteral treatment and jaundice were significant risk factors for hepatitis B and C carrier status. There appears to be a strong co-relation of history of blood transfusion and dental treatment with HbsAg/ Anti HCV carrier state in pregnant women. The anti HCV seropositivity was appreciably high [80%] as compared to HbsAg [20%] in carrier pregnant women

review of 100 cases of ocular trauma admitted in eye ward. Presentation, management and visual outcome

To report different causes of ocular trauma in hospital admitted cases, their mode of presentation, management and visual outcome and to explore possible methods of reduction of ocular trauma in our setting. Hospital based retrospective descriptive and Observational study. The study was conducted in eye department of Bahawal-Victoria hospital from August 2007 to August 2009. 100 patients with first time ocular trauma of any age and sex were included in this study. Previous ocular trauma or ocular surgery patients were excluded. Visual acuity on presentation, rupture of globe, perforating injury, retinal detachment, endophthalmitis, intra-ocular foreign body and need for surgical intervention and visual outcome were determined. Out of 100 patients 88% were male and only 12% were females. 67% patients presented before 8pm. Majority [32%] of the cases were between 21-30 years of age. Open globe type injury [73%] was more common than close globe type [27%]. Most tears [46.57%] were corneal while 9% cases had FB in anterior segment and 17% in posterior segment. Regarding management 23% were managed medically while 77% required combined medical and surgical treatment. Despite of treatment, 12% eyes lost total vision due to phthisis bulbi, endophthmitis, and non-attachable retinal detachment. Ocular trauma in hospital admitted cases carries poor visual outcome due to severity and nature of trauma, late presentation, associated infection, poor socio-economic status. Visual outcome is dependent on location of wound, cleanliness, prompt and timely diagnosis and management

Bilateral protrusion of femoral head into the pelvis in neglected osteomalacia

Osteomalacia is a metabolic bone disease in a mature individual, caused by lack of vitamin D or its active metabolites, on account of a number of factors. Osteomalacia is common in females and in countries with less sun shine. It typically presents with body aches, weakness, alongwith signs of bone tenderness and proximal myopathy. Diagnosis is made on the basis of clinical presentation and investigations; serum calcium, phosphorus, serum alkaline phosphates, 24 hour urine for calcium and phosphorus and skeletal radiology