Long-term performance of exteriorized femoral stem after cortical perforation in revision cemented total hip replacement

This is the first published report of a long-term, fourteen years close annual follow-up of a patient who underwent revision total hip replacement with per-operative anterior cortical perforation of femur while undertaking cemented femoral stem insertion. This patient has complete satisfaction in terms of clinical and radiological outcome. This patient has been walking full weight bearing on her operated leg after 3 months of her surgery. We advocate for the need of paying meticulous attention to observe this complication on operative table and to proceed with controlled stem insertion where doubt exist. Such patients may require a vigilant regular annual follow-up to observe their clinical and radiological status and an expectant approach may be adopted unless patient becomes symptomatic

Patella dislocation association with drop foot

All limb injuries should be examined with complete documentation of neurovascular assessment as they are often ignored in the busy emergency department setup. This may lead to delay in such diagnosis during the treatment of limb injuries at a follow-up in orthopaedic clinics. Early diagnosis can help orthopaedic team to investigate and start treatment which may help in the recovery of such neurovascular injuries. We report a case of missed neurovascular assessment in the emergency department on a patellar dislocation of a young person leading to foot drop and sensory numbness in the deep peroneal nerve distribution, which improved completely within three and a half months with conservative treatment. This is also the first reported case of foot drop in association with patellar dislocation

[ effect of Ramadan fasting on serum osmolraity, some electrolytes and hematological parameters]

During the month of Ramadan, 400 million adult Muslims all over the world fast during daylight hours. The effect of Ramadan fasting has been studied in various investigations conducted on normal healthy individuals world wide, but the changes of serum osmolarity and hematological parameters during Ramadan fasting are not known well. This cohort study was performed during Ramadan on 80 medical students [41 male and 39 female]. We evaluated weight, Body Mass Index [BMI], serum osmolarity, sodium and potassium, haemoglobin[Hgb], hematocrit [Hct], platelets, red and white blood cell count [RBC and WBC] and Hgb Index before and after Ramadan. The mean age of subjects was 22.7 years. Weight decreased significantly in both genders, and BMI decreased in female subjects after ramadan. While serum osmalarity and sodium increased and glucose decreased in both genders after ramadan, potassium decreased in males. RBC count increased in both genders, but WBC count and platelet count increased significantly in females. Hgb, Htc decreased after Ramadan Fasting in male subjects. We found no significant changes in levels of urea and creatinin in serum. This study indicated that Ramadan fasting leads to increased serum osmolarity, RBC count and some Hgb indices in both genders, but these changes remain within normal range. However, more investigations are suggested of patients with hematological and nephrological disorders

Socioeconomic differences in housewife's ability to take nutrritional care

To explore socio-economic differences in 'Nutritional Care Potential' [NCP] of housewives belonging to three distinctively different income groups living in urban areas of Karachi. Data was collected from families living in small, medium and large sized houses located in the authorized urban residential areas of Karachi. A total of 180 housewives [60 each for low, middle and high income groups] were interviewed. Trained data collectors visited the households, interviewed the housewives about family's socio-demographic characteristics and their own nutritional knowledge, health locus of control and decision making. The total NCP scores increased with income level [Low = 14.8+5.6; Middle 16.58+5.5; High = 17.28+5.3] but the difference was statistically significant only between low and high income groups [t-test P = 0.015]. The mean nutrition knowledge score of low income group was lower [mean score = 11.7+4.1] and significantly different from both middle [mean score = 13.5+3.4 t-text P = 0.013] and high income group [mean score = 14.2+4.0, t-test P = 0.001]. All the three income groups had firmer belief in internal health locus of control [mean score less than one out of a total of 4]. Though, the mean score was highest for the high income group and lowest for the middle income group but the difference were not statistically significant. There were no marked differences in decision making power of the three groups. The results of this study document socioeconomic difference in nutrition care potential. Though nutrition care potential of housewives was not found to be commendable at any income level, the fact that it is low at lower income levels indicates that poor nutritional status at lower income level is not because of income only

Food insecurity in metropolis of the developing world - observations from central district of Karachi, Pakistan

To asses the prevalence of household food insecurity at various income levels in urban areas of Karachi A cross sectional survey of different localities in the central district of Karachi was carried out. The data was collected through household interviews of housewives conducted by trained nutritionist. Housewives were interviewed about food security status of the household. A total of 797 families were visited from the central district of Karachi. Mean Food Security Score increased with income level. The difference was statistically significant [ANOVA] between 1st and second [P=0.000] and 2nd and 3rd group [P=0.000] but not between 3rd and fourth group. At the very low and low income levels 83% and 51% families respectively were food insecure in any degree, while this percentage was very low at the middle [6.3%] and high income level [1.8%]. The difference in prevalence of food insecurity between the VLI and LI, and, LI and MI income groups was statistically significant [chi.sq. test, p<0.001 in each case]. Hunger [because of lack of money] was experienced in the preceding year only by "very low income" [37%] and "low income" families [17%]. Use of coping strategies was most frequently mentioned for parents and then for children and only occasionally for infants or grand parents. Females were more likely to be effected by food insecurity than males. Meat, milk and fruits were the food groups which were preferred and considered healthy but were avoided because of lack of money by a majority [51%-86%] of families. Conclusions: In spite of having an impression of being an affluent city of Pakistan, the prevalence of food insecurity with and without hunger is rampant not only among very low income [slum dwellers] but also among low income families of Karachi

Is carcinoma breast a different disease in Pakistani population?

Carcinoma of the breast tends to be different in coloured and white races. Is this pattern also expressed in Pakistani population

Prevalence of HBV markers in health care personnel VS matched control

One hundred forty five Health Care Personnel [HCP], and 76 Matched Control [MC], were screened for Hepatitis B virus [HBV] seromarkers namely HBsAg, Anti HBc and Anti-HBs, by Radio immunoassay. Seventy seven percent [77%] of HCP and 79% of controls were found to be positive for one or the other marker. There was remarkable difference, in the prevalence of HbsAg in both the groups and it was 7% in HCP and 26% in MC. The other seromarkers were almost similar in frequency in both the groups. Immunity to HBV was seen in 45% of HCP and 28% of MC. The study suggested that Health Care personnel were not at a high risk for acquiring HBV markers than the rest of population in Pakistan and that they had evidence of greater immunity against HBV as compared to MC

Prediction of shelf-life of packaged paracetamol tablet formulations

Shelf - life prediction of a number of commercial packaged paracetamol tablet formulations exposed to various conditions of temperature and humidity has been investigated by accelerated stability analysis. The shelf - lives [t90 at 25