clinical audit on venous thromboembolism prophylaxis of medical patients in west medical ward, Mayo Hospital

To reduce risk of Deep Venous Thrombosis/ Pulmonary Embolism in an acutely ill hospitalized medical patient and the consequent clinical complications. The study was carried out in the West Medical Unit of Mayo Hospital, Lahore from January, 2005 to May, 2005. A total of 100 cases were selected from the patients hospitalized in the ward on the basis of presence of risk factors with no contraindications to heparin prophylaxis, taking into account the age, gender, final diagnosis of the patient, the existing risk factors, the risk stratification, the exclusion criteria, whether heparin prophylaxis was given or not, if given type of heparin administered, and whether patients receiving prophylaxis were monitored or not using Platelet Count, APTT or other monitoring techniques. 19 cases were under Moderate Risk of developing Venous Thromboembolism [VTE] and 81 cases were under High Risk. 7 received Heparin prophylaxis. 3 of them were at Moderate Ri sk and 4 cases at High Risk of developing VTE. All acutely ill medical adult patients admitted should be adequately assessed and screened for presence of Risk Factors and categorized according to the SAVE Risk Stratification. In the absence of Exclusion factors, all cases of High Risk and Moderate Risk should be started on Heparin Prophylaxis as early as possible in hospital admission. The audit should be repeated for re-evaluation after adequate time

audit of indoor morbidity and mortality in a medical ward at a tertiay care, hospital

There is a great geographical variation in disease burden around the world, which is due primarily to environmental, genetic, social and economic factors. Similar variations exist in worldwide mortality figures from a particular disease that can be attributed almost entirely to the access and efficacy of healthcare facilities. We did this audit to identify the major causes of morbidity and mortality in patients admitted in a medical unit of a tertiary care hospital and to highlight the importance of primary prevention. The audit was carried out in West Medical Ward Mayo Hospital Lahore, Pakistan from 1st January 2004 to 31st December 2004. All patients admitted with medical problems from the Outpatient and Emergency Departments were included. During the year 2004, a total of 2045 patients were admitted, out of which maximum number of patients admitted in the ward were suffering from chronic liver disease [17%] followed by ischemic heart disease [14.4%] cerebrovascular accidents [10.4%] and renal diseases. Total number of deaths were 321 with male mortality was 167 [14.40%] and female mortality 154 [17.40%]. Chronic liver disease also had the highest mortality [16.8%] followed by cerebrovascular accidents [14%], renal disease [11.5%] and ischemic heart disease [7.8%]. Even the mortality due to chronic liver disease was significantly higher [p <0.01] than ischernic heart disease. The number of patients having the four common diseases having age 45 years or more [770] was significantly greater [p <0.0001] then the number of patients [279] in the age range of 15 to 44 years. It was observed that significantly greater number of male patients [595] had morbidity than females [462], [p <0.0001], while mortality has no difference. Chronic liver disease, ischemic heart disease and cerebrovascular accidents are the diseases putting maximum burden on our health resources and disabling our productive population. This audit highlights the fact that all these three groups of diseases can be prevented and thus obviates the need of primary prevention of these major killers

Occupational hazards for surgeons

In spite of the radical advances made in the field of surgery to save lives, we find it is the surgeons who are becoming the patients by being exposed to a host of occupational hazards, which places them at a significant risk of acquiring many infectious diseases in addition to other safety threats. In context to guidelines set down by International Labor Organization the hazards a surgeon can face at work can be broadly categorized into Accidental, Chemical, Biological, and Ergonomic, Psychosocial and Organizational Hazards. To identify the occupational hazards surgeons face in our set-up and their inevitable consequences as compared to international standards. Setting The survey was carried out in a major tertiary care hospital of Lahore with inspection of operation theatres, surgical emergency room, and surgical wards. The surgeons in our setup are exposed to infectious diseases such as Hepatitis B and C, HIV and typhoid via accidental pinpricks from infected needles and s harps due to multiple hazards. Other risks include latex sensitization, back problems, post-traumatic stress syndrome and many others. Spread of awareness of these occupational hazards should be undertaken with a change in attitudes

Germination ecology of bunium persicum [Bois] fedtsch and ferula oopoda [Boiss and Buhse] boiss

The study revealed that Bunium persicum seeds had 70% germination at 5 °C, while those of Ferula oopoda had 100% germination at 10 °C. Stratification improved the rate of germination in both the species. The germination of Bunium persicum improved [80-86% when treated with dry air or ethylene gas. Treating seed with acetone, ether, alcohol, soaking in cold and boiling water and application of KNO3, and thiourea did not improve germination in both the cases. Seed stored for 2 years exhibited 96-100% germination in each case. The germination was 40% in B. persicum seeds in sandy clay loam, while F. oopoda gave 100% germination in sandy clay loam and silt loam and 80% in loamy sand and clay loam soils. The germination of both these species generally decreased with increasing sowing depth and soil dryness as they appear to be stenothermal as far as their germination is concerned