Asphyxial deaths: a four year retrospective study in Peshawar

The study provides epidemiological analysis of autopsy record on asphyxial deaths and different methods used to carry it out. It was a retrospective [descriptive] study done at the Department of Forensic Medicine and Toxicology, Khyber Medical College Peshawar. Analysis of autopsy record was done and cases of asphyxial deaths and the cause of asphyxia was noted. The data covers a period from January 2009 to June 2012. A total of 3,265 [males n=2839, Females n= 426] cases were presented for autopsy to Forensic Medicine and Toxicology Department of Khyber medical college Peshawar and 130 deaths were due to asphyxia compared with 2370 deaths due to firearm. Homicide was the most common manner of death. 89 cases were males and 41 were females. Approximate ages of the autopsies conducted were 0-19 years n= [18.2%], 20-40 years n= [64.5%], 41-60 years n= [13%] and 61 or above n=4 [3.0%]. Strangulation was found to be the most common method used. Asphyxial deaths are not as common as firearm deaths in Peshawar. Homicide is the most common method of death. The findings may be helpful for the security agencies in investigation of asphyxial deaths

MRI brain findings in patients with high serum prolactin levels

The purpose of the study was to find MRI findings in patients with Prolactin levels above1000mIU/L. Methodology: This Retrospective study was conducted in Radiology Department, Rehman Medical Institute,Peshawar, from December 2009 to October 2012. A total of 86 patients, aged 16-48 years with high Prolactinlevels, were screened with MRI for pituitary gland abnormalities. Only new undiagnosed patientswere considered for the study. Children and patients with known causes for hyperprolactinaemia wereexcluded.The most common abnormality on MRI was microadenoma [n=34, 39.5%] followed by macroadenoma[n=14, 16.3%]. 12[7%] cases of complete/partial empty sella syndrome were seen. Macroadenomawas more common in males [n=6 out of 14, 42.3%] while microadenoma was more common in females[n=32 out of 72, 44.4%]. Majority of Patients had an abnormal MRI finding, showing that MRI screening should berecommended for Prolactin levels above 1000mIU/L. Microadenoma was the most common abnormality,having higher incidence in female patients

Analysis of autopsy record of unnatural deaths in Peshawar district

This study was undertaken to describe the unnatural deaths and their causes in Peshawar and its suburbs. This descriptive study was conducted at the Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar. Autopsy data from January 2009 to April 2012 was analyzed and only those cases were selected for the study where the cause of death was unnatural i.e., homicide, suicide, accidental or undetermined. Of a total of 3,265 autopsies due to unnatural causes during 40 months period, 2,839 [87%] were males and 426 [13%] were females. There were 2,856 cases of homicide - 2,475 [87%] were males and 381[13%] were females, 317 were accidental deaths - 281 [89%] males and 36 females [11%], 66 were suicide cases - 61 [92%] males and 5 females [8%] and 26 were undetermined deaths - 22 males [85%] and 4 [15%] females. Most victims were aged 20-40 years. Most common cause of death was firearm - 2370 cases, blunt trauma 279 cases and bomb blast/explosives 167 cases. The rate of unnatural deaths in Peshawar is very high. Autopsies done during the study period were a lot more than previous years. Homicide is the most common manner of death with firearms being the most common weapon used. Strict laws should be implemented to limit illegal weapons. Surveillance must be increased in all parts of the city to reduce the loss of precious human lives

Resistance and sensitivity pattern of Staphylococcus aureus; a study in lady reading hospital Peshawar

This study was done to determine the sensitivity and resistance pattern to the most common antibiotics in use. The data for this retrospective study was obtained and analysed from October 2010 to October 2011 in Lady Reading Hospital, Peshawar. Purposive sampling and univariate analysis was done. 2058 samples were cultured for sensitivity using Kirby Bauer's Diffusion technique and in a period of one year, growth of Staphylococcus aureus was obtained in 723 samples. These 723 growths were obtained from clinical isolates of pus [699], blood [16] and urine [8]. Fourteen drugs from five different classes of antibiotics were tested for sensitivity against Staphylococcus aureus. Most of the growth was obtained from pus [96.7%]. Resistance was high to all groups of antibiotics except glycopeptides. There was no case of Vancomycin Resistant Staphylococcus aureus [VRSA]. Out of 723 samples, 228 [31.5%] were Methicillin Resistant Staphylococcus aureus [MRSA]. The resistance to a representative antibiotic of each group is as follows: Ciprofloxacin [Fluor quinolone] 51.7%, Cephradine [Cephalosporin] 46.2%, Amoxicillin+Clavulanic Acid [Penicillin group] 45.6%,Imipenem+Cilastatin Sodium [Carbapenem] 42.0% and Teicoplanin [Glycopeptide] 19.8%.Resistance of Staphylococcus aureus to Teicoplanin and most of the antibiotics is high and strict guidelines are required to control unnecessary prescriptions and over the counter sale of antibiotics

Coverage and causes of non immunization in national immunization days for polio; a consumer and provider perspective study in Peshawar

Polio is a viral disease that may cause paralysis and infant death. Despite ongoing efforts, polio has not been eradicated from Pakistan. The purpose of this survey is to estimate the coverage of polio vaccine during National Immunization Days and to determine the factors associated with lack of immunization. A Cross-sectional survey was conducted in Peshawar, Pakistan, from 1[st] June to 9[th] June 2010. Confidence level of 95% and confidence interval of 4 was used to derive the sample size [for a population more than 20,000]. Parents of 600 children under 5 years were asked about immunization during NIDs of January - May 2010 [5 NIDs]. Questions regarding demographics, income, education, occupation, accessibility to health centers and frequency of visits from health workers was inquired. Knowledge and views on immunization were also asked. 40 health personnel involved in immunization were also interviewed and they were asked about hurdles faced in immunization. 83.7% children were vaccinated in all National Immunization Days, while 94.7% had at least, taken polio vaccine once. 5.3% had not taken polio vaccine during National immunization Days of 2010. Main reasons for not vaccinating were; Vaccinator absent/not visiting home/vaccine not available [63.36%], no awareness [17.4%], Child ill [5.8%], family problem/mother busy [3.3%] and wrong ideas/sterility [3.3%]. Many health personnel [32.5%] considered lack of awareness among people and low accessibility to vaccine as the main hurdles in immunization, besides the poor salaries and incentives. Polio vaccination during National Immunization Days 2010 was a partial success because some pockets of poor children and afghan refugees were poorly vaccinated. In order to eradicate polio, they must be vaccinated

Coverage and causes of missed Haemophilus influenzae type B vaccination in urban and rural areas of Peshawar

Haemophilus influenza type b [Hib] is a major cause of morbidity and mortality in Pakistan. Hib vaccine was introduced in 2009 in EPI programme. The purpose of this study was to find out the coverage and factors associated with non-immunization of Hib in urban and rural areas of Peshawar. Data was collected through random sampling in Peshawar University, Peshawar Saddar, Hashtnagri, Naway Kalay and Pawaka from 9th to 19th of June 2010. A questionnaire was used to interview parents of 600 children aged 1 year and below about demographics, Hib vaccination status, reasons for missed vaccination and views on immunization. Pearson's Chi-square test was used for statistical testing, and p<0.05 was considered significant. Completely vaccinated children were 64.2%, 25% not vaccinated at all, and 11% were incompletely vaccinated. The reasons for not vaccinating were lack of awareness [26%], family problem/mother busy [18%], centre too far [16.9%], wrong ideas [12.2%], fear of reaction [5.4%], child illness [8.1%] and miscellaneous causes [13.7%]. Low Hib vaccination coverage in Peshawar is mainly due to low awareness among people, poor economic conditions and illiteracy