Knowledge and practices of mothers for complementary feeding in babies visiting pediatrics outpatient department of Jinnah Hospital, Lahore

To assess the knowledge and practices of complementary feeding among mothers attending Paediatrics outpatient department. A cross - sectional study was conducted in Pediatrics OPD Jinnah Hospital Lahore from march - september, 2012. A total 250 mothers of the babies aged 6 - 12 months were selected by non-probability purposive sampling technique. Their knowledge and practices regarding complementary feeding was assessed by using a close ended pre-tested questionnaire. Nine questions were asked for knowledge and eight questions for practices. Data analysis was done by using 'Likert's scale' and each correct answer was given one mark. The knowledge and practices was ranked as good, satisfactory and poor depending upon the overall score. If score was more than 70%, it was regarded as good, if 50 - 70%, satisfactory and if less than 50% then it was considered as poor both for knowledge and practices. About 79.6% mothers exclusively breastfed their babies and 84% continued breastfeeding along with complementary feeding. The correct knowledge of initiation of complementary feeding was found in 54% of mothers but it was practiced by only 43%. The overall knowledge of 24% mothers was good and 28% had poor knowledge of complementary feeding whereas only 7% women had good overall practices. There is statistically significant association of education of the parents with the practices of complementary feeding [p-value = 0.012 and 0.0295 of mothers and fathers]. Occupation of the mothers and type of family had also shown statistically significant association [pvalue = 0.018 and 0.001 respectively] with the overall practices about complementary feeding. More than one third of mothers had poor overall knowledge regarding complementary feeding and a very few mothers had good overall practices. Education of parents, occupation of mothers and type of family had statistically significant association with complementary feeding

Hepatocellular carcinoma; characteristics a retrospective study of 34 patients at JHL, Lahore

Hepatocellular carcinoma [HCC] is the commonest primary malignant cancer of the liver in the world. Characteristics of our population suffering from HCC are not known, this study aims to present epidemiological, clinical and laboratory characteristics of HCC patients. A retrospective study. At Jinnah hospital, Lahore. 36 months. HCC was diagnosed according to the guide lines given by EASL-2000. The data was later analyzed by SPSS13. A total of 34 patients were included in the study. Majority patients were male 21[80%] and belonged to urban setting [21]. Pain abdomen 21[61.8%] and Ascites 22[64.7%] were the commonest presentations. 15[44%] patients were suffering from HCV and 12 [35.3%] were negative for both HCV and HBV, while 9 out of these were also not alcoholic. Most of the patients had symptoms present for 1 -6 [76%] months and majority presented in either stage III or IV [91%], none of the patient presented in stage I. Most the patients 25 [73.5%] had tumor size larger than 5 cm at presentation and similarly 20 [59%] had more than one lesions at presentation, stage of tumor was positively associated [p <0.02] with number of tumor lesions. HCC does occur in a cirrhotic background but a good number of patients were not cirrhotic and need to be investigated further for other possible dietary risk factors. Pain and abdominal distension in a cirrhotic patient should be addressed to immediately so as to diagnose HCC at an earlier stage

Recurrent goiter: is it preventable?

To determine the different factors responsible for the recurrence of goiter after surgery. Department of Surgery, Fauji Foundation Hospital, Rawalpindi from January 1998 to December 2005. All patients with recurrent goiter irrespective of place of first surgery were included. The patients with recurrent goiters due to thyroid malignancies were excluded. Sixty-four patients were included during study period from January 1998 to December 2005. 34.38% were in 4[th] and 25% of patients reported in 3[rd] and 5[th] decade each. Among them 96.9% were females and 3.1% males. 46.88% patients noticed recurrence after 4-6 years and 28.13% after 6-7 years of surgery. 75% of patients had not used thyroxin at all and 25% used for some duration after surgery. None of the patients gave the history of continuous use of suppressive dose of thyroxin postoperatively. During surgery it was observed that the site of recurrence was 25% whole one lobe, 18.75% from both lobes or at multiple places, 12.5% from pyramidal lobe and 9.37% from superior pole. Adequate thyroxin prophylaxis, correct indications for primary surgery, adequate surgery and removal of all palpable nodules reduce the risk of recurrent goiter

Recurrent laryngeal nerve injury: an experience with 310 thyroidectomies

Thyroid surgery has been associated with complications ranging from nerve injury to death. Improvements in techniques have reduced the mortality rate to minimum. Morbidity, however, remains a significant concern. This study was designed to determine the prevalence of recurrent laryngeal nerve [RLN] injury and duration of recovery following transient recurrent laryngeal nerve injury, during thyroid surgery. This prospective, observational study was carried out in the Surgical Department of Fauji Foundation Hospital, Rawalpindi, from January 2000 to December 2005. All patients undergoing Thyroid surgery were included. 310 patients, predominantly female [97.09%], were operated. Majority were euthyroid [90.33%]. 3.22% patients had recurrent laryngeal nerve injury. Amongst them, 87.5% had transient and 12.5% had permanent nerve lesion. Majority of the patients [87.5%] showed signs of recovery within 12 weeks after surgery. Injury was observed more in huge goiters [3.57% transient and 1.42% permanent], total thyroidectomy [7.69% transient and 3.84% permanent] and during lobectomy and total thyroidectomy [6.25% respectively for transient and permanent nerve injury. Thyroid surgery should be done by experienced surgeon and care should be taken especially in huge goiters and patients undergoing total thyroidectomy