Diagnostic yield of fine needle aspiration cytology and biopsy [FNAC/FNAB] in thoracic mass lesions

To describe the diagnostic yield of USG and CT guided fine needle aspiration cytology/biopsy [FNAC/FNAB] in the bronchogenic carcinoma presenting as localized thoracic mass lesions. Descriptive study. This descriptive study was carried out in the Pulmonology Department, Nishtar Hospital, Multan from March 2011 to Oct 2011. A total of 60 patients were included in the study. All the patients were subjected to bronchoscopy first and then FNAC/B. Out of 60 patients, 40 [66.66%] were males and remaining 20 [33.33%] were females. As regards age of the patients, Most of the [36%] were in the age group 41-50 years. Of the total 60 patients 28 [47%] were smoker. Majority of the patients [72%] belong to urban areas. Chest radiograph showed right lung involvement in 36 [60%] cases. USG guidance was sought in 15 [25%] cases where as CT guidance was taken in 45 [75%]cases [FNAC] was also done in all cases with radiological/USG/CT guidance in all cases. Out of 60 cases, 37 [61.6%] were suffering from primary malignancy of lung [Table-4]. Out of 37 cases of malignancy the squamous cell carcinoma was confirmed in 18 [48.6%] cases. It is concluded from the study that percutaeous aspiration biopsy/cytology of the lung has a definite diagnostic role in lung lesions particularly those situated peripherally. FNAC/FNAB is especially more useful in those lesions not visible through bronchoscopy. FNAC is safe procedure especially when guided by computed tomography [CT] or USG

Peak expiratory flow rate; comparison of cotton mills workers and healthy controls in Multan

To ascertain the effects of cotton dust on the peak expiratory flow of cotton mill workers in comparison with the healthy controls who never exposure to the cotton dust. Outpatient Department of Pulmonology, Nishtar Hospital, Multan. August 2011 to March 2012. A total of 200 male subjects [100 healthy controls and 100 cotton mill workers] who strictly met the inclusion criteria were selected from the OPD. The peak expiratory flow rate [PEFR] [L/min] of cotton mill workers was significantly lower as compared to the control subjects and this impairment was directly proportional to the duration of exposure to the cotton dust in the mail. It was concluded from the study that the peak expiratory flow rate was decreased in the cotton mill workers

Pleural effusion; Pattern at Nishtar hospital, Multan

To determine the frequency of various diseases presenting with pleural effusion. Department of Chest Medicine, Nishtar Hospital, Multan. March 2010 to September 2010. A total of 100 patients both sexes, more than 12 years old, with clinically and radiologically confirmed pleural effusion underwent diagnostic thoracocentesis. Pleural fluid was examined grossly and for sugar, protein, LDH, total and differential white cell count and malignant cells. Pleural fluid culture and pleural biopsy was done in case of exudative effusion. Tuberculosis was the most common cause [28%] of exudative pleural effusion followed by parapneumonic effusion [25%] and malignant effusion [9%]. Congestive cardiac failure [13%] and liver cirrhosis [8%] were the commonest cause of transudative pleural effusion. Renal failure [5%], nephritic syndrome [2%], pancreatitis [2%], systemic lupus erythmatosus [2%] were the other significant causes of pleural effusion. Tuberculosis, paraneumonic effusion and malignancies are the common cause of exudative pleural effusion while congestive cardiac failure, liver cirrhosis and nephritic syndrome are common causes of transudative effusion.

effect of cotton dust on peak expiratory flow on cotton mill workers on comparison with the healthy controls in Multan

The prevalence of occupational diseases has increased progressively for the past two decades. Worldwide it has been estimated that 15% of adult onset asthma is caused by occupational exposure 35. WHO keeps on formulating and revising its guidelines regarding the prevention of occupational hazards but, because of poor implementation, especially in the third world countries including Pakistan, work-related ailments are becoming a challenge for the health sector. Pakistan is an agricultural country with cotton as it cash crop. A lot of manpower related with the cotton textile industry. Byssinosis is a disease related with the cotton dust and we lack the data at national level about the health of our cotton mill workers. It was therefore considered worthwhile to conduct the present study. To ascertain the effects of cotton dust on the peak expiratory flow of cotton mill workers in comparison with the healthy controls who never had exposure to the cotton dust. Subjects exposed and not exposed to cotton dust were analytically studied. The study was carried out at the out patient Department of Pulmonology department, Nishtar Hospital, Mullan. Six months from Oct 2006 till April 2007. A total of 200 male subjects [100 healthy controls and 100 cotton mill workers] who strictly met the inclusion criteria were selected from the OPD of pulmonology department. The peak expiratory flow rate [L/min] of cotton mill workers was significantly lower as compared to the control subjects [P<0.05] and this impairment was directly proportional to the duration of exposure to the cotton dust in the mill. The present study, concluded that the peak expiratory flow [L/min] was decreased in the cotton mill workers. This impairment is directly proportionate to the duration of exposure. The health status of the cotton mill workers was found unsatisfactory in the southern Punjab. It was therefore, strongly recommended that the mill, workers should be properly educated to adopt the-protective measures like masks, gloves, goggles etc, and also they should be kept under periodic medical surveillance

Association of dyslipidemia with acute and myocardial infarction

Ischaemic heart disease is a leading cause of death throughout the world. CAD has been recognized among all age groups especially above forty years of age more frequently in recent years. To determine the dyslipidaemia and waist hip ratio as a risk factor of Myocardial Infarction [MI]. This descriptive comparative type of study was conducted in the medical Ward, Nishtar Hospital, Multan during the period from January 2006 to January 2007. A total of 150 patients of first acute myocardial infarction age ranges from 35 years-70 years were included in the study. Among these patients 74% were males and 26% females. Two modifiable or controllable risk factors including dyslipidaemia. [Truncal obesity] were studied in this study. Patients were diagnosed on he bases of typical history of chest pain, ECG changes, raised cardiac enzymes or troponin T positive. Fasting lipid profile was done. Dyslipidaemia i.e. high total cholesterol, low density lipoproiein cholesterol and low HDL-cholesterol was statistically significant in all patients of ML 74% patients have dyslipidaemia including high total cholesterol, high LDL-C and low HDL-C. Triglyceride level was not found statistically significant. Incidence of IHD showed linear relation with age i.e. risk increased with the age only 14% patient belonged to age group 35-30 year as compared to 34%i patient who belong to age group more than >50 years. Mostly females were post-menopausal. It was also found that upto 80% had two or more than two risk factors. In conclusion, dyslipidaemia and Truncal obesity are important modifiable risk factors. These risk factors must he sought out in all high risk groups and where possible be treated for both primary as well as secondary prevention of CAD

Pattern .of pulmonary tuberculosis and its associated complications amongst health care workers in a tertiary care hospital

To find out the pattern of pulmonary tuberculosis and its associated complications among health care workers in our hospital set up. Nishtar Hospital, Multan. It was a simple descriptive study. January 2003 to December 2004. The study was conducted among health care workers [Doctors, Nurses, Nursing students, and other paramedics like Lab. workers, ward assistants and cleaners], serving in the hospital for more than one year in the Medicine and Allied, Surgical and Allied and Pathology department. Among doctors, one case of active disease was detected [2.85%] while inactive disease was found in 4 subjects [11.4%]. Tuberculous infection rate was found to be 65.7%. Among nurses, 3 were detected having active [11.5%] and 5 inactive disease [19.2%]. Among nursing students, 4 were suffering from active disease [20%] and 3 inactive disease [15%]. The study showed that tuberculosis remains an occupational hazard for HCW

Diagnostic yield of fine needle aspiration cytology and biopsy [FNAC/FNAB] in localized lung lesions

Bronchogenic carcinoma is towards increase day by day and today remains the leading cause of cancer death in both sexes. Tobacco smoking, increasing industrialization, environmental pollution and certain occupations are the major risk factors associated with bronchogenic carcinoma. To describe the diagnostic yield of fine needle aspiration cytology/biopsy [FNAC/FNAB] in the bronchogenic carcinoma. All male and female patients above the age of 12 years with clinical and radiological evidence of a localized lung mass with strong clinical suspicion of malignancy were included. All patients with proved cystic or vascular lesions and those with lesions looking clearly as consolidation on radiograph were excluded. The age ranged from 18-72 years. In a total of 50 cases, 35 [70%] were male and 15 [30%] were female. Out of 50 patients, 38 [76%] belonged to urban area and 12 [24%] belonged to rural area. Details about the smoking habits along with type, degree and duration of smoking were obtained in all cases. In present study the commonest symptom was cough present in 40 [80%] cases, followed by chest pain in 35 [70%]. Anemia was found to be most common sign and it was detected in 18 [36%] cases followed by clubbing or the fingers, 15 [30%] cases. Chest radiograph showed right lung involvement in 28 [56%] cases and left lung was involved in remaining 22 [44%] cases. The lung has definite diagnostic role in lung lesions particularly those situated peripherally

Comparison of bronchoscopy and FNA in diagnosing local lung lesion [centrally located and peripherally located]

To compare the results of Bronchoscopy and FNA in diagnostic local lung lesion. This descriptive study of 50 patients was conducted in the Pulmonary Department of Nishtar Hospital, Multan during the period of one year extending from September 2003 to August 2005. The youngest patient in the study group was an 18 years old boy, while the oldest patient was also a male of 72 years male to female ratio was 2.3:1. In a total of 50 cases, 25 [70%] were male and 15 [30%] were female. Sex distribution is shown in. The incidence of complication was very low. Out of 50 cases in which FNAC was performed only 11 [22%] patients complained of chest pain at the site where FNA was done. The overall diagnostic yield of FNA in localized lung lesions in high in this study [86%]. Frequency of complications with fine needle aspiration is very low. FNA is more useful in our setting where patients cannot afford more expensive procedures