Relationship between anaemia and simple febrile convulsions

Simple febrile seizures are the commonest convulsions occurring in children and its exact pathophysiology is unknown. Among other postulated reasons anaemia has been thought to be a possible aetiology. This study was conducted to find out any relationship between anaemia and simple febrile convulsions. We studied notes of 1,951 patients retrospectively who were admitted in the Women and Children Hospital Abbottabad from Jan 2013 to Aug 2013. Thirty-one patients with febrile seizures were included in the study as group I and another 31 patients matched for the demographic data were taken as group II. Degree of temperature, family history of simple febrile convulsions, underlying focus of infection and haemoglobin level were recorded. Sixty-eight percent of patients in group I had Hb level below 11 gm/dl compared to 39% of patients in group II; 32% patients of group I, had level on/above 11 gm/dl but none of them had Hb above 11.5 gm/dl in comparison to group II where 61% had Hb level on/above 11 gm/dl with upper limit of 13 gm/dl. Significant association was found between anaemia and Simple Febrile Convulsions

Modified posterior sagittal ano-rectoplasty: a new approach for the management of ano-rectal malformations in children

To introduce a technical modification in Posterior Sagittal Ano-rectoplasty [PSARP], commonly known as Pena's procedure, and to analyse the outcome of such modified procedure in terms of fecal continence and other relevant complications in children with ano-rectal malformations. It was a prospective and descriptive study, conducted at the department of pediatric surgery, Lady Reading Hospital Peshawar from January 2004 to December 2006. Forty patients were studied. All children of either sex with ano-rectal malformation who presented first to our department were included in our study excluding others treated some where else. Relevant investigations were performed in all patients. Diverting colonic or small bowel stoma was created in all patients at presentation to our department. The technique was performed at or after six months of age, depending upon the clinical condition of the patient. After discharge, all patients were examined and monitored in the out-patient department over a period of two years. Out of 40 patients 25[62.5%] were male and 15 [37.5%] were female age range from 6-12 months. On 35 [87.5%]. Isolated PSARP while on 5 [12.5%] patients modified PSARP with abdominal approach were performed. Anal stenosis was found in 3[7.50%] patients, rectal mucosal prolapse in 4[10%], faecal soiling and faecal incontinence in 17[43.58%] and 7[17.05%] patients were respectively. Faecal continence was good, fair and poor in 15[38.46%], 17[43.58%] and 7[17.94%] patients respectively. Our results of the present series suggest that this procedure is a valuable alternative to PSARP for the treatment of anorectal malformations

Inadequacies in history taking and clinical examination by the dentists

History taking and clinical examination are the most important steps in the diagnosis and hence overall patient management in medicine, surgery and dentistry. The purpose of this study was to determine the history taking and clinical examination practices of dentists. Self-administered questionnaires were distributed among two hundred randomly selected dentists of Rawalpindi and Islamabad. The questionnaire assessed how often these dentists recorded all the steps of history and how often they examined their patients thoroughly. While the vast majority of dentists asked most of their patient's demographics, chief complaint and the history of their chief complaint and examined all teeth of their patients, a considerable number of them missed the medical, family and socioeconomic history, did not record vital signs, and did not examine the entire head and neck and oral mucosa of all their patients. This study emphasizes deficiencies and inadequacies in the history taking and clinical examination practices of dentists in the studied sample

Waist hip ratio as an index for identifying women with raised TC/HDL ratios

Background: Obesity cannot be described solely as fat mass but the location of fat deposition is very important to determine the relation between obesity and disease. Abdominal type of obesity is linked to risk factors of atherosclerosis and to metabolic disease. Waist Hip Ratio [WHR] is a practical, simple and non-invasive index of adipose tissue distribution

Methods: We looked for a relation between WHR and TC/HDL-C ratios of a group of postmenopausal women. All the subjects in each major group were of comparable age and BMI, but the WHR varied from subject to subject. Each group was sub-divided into three tertiles based upon the WHR. Serum total cholesterol [TC] and HDL cholesterol [HDL-C] values were determined for all the subjects and TC/HDL-C ratio, which is a recognized CHD risk screening index was calculated

Results: The WHR distribution was significantly different in postmenopausal women from the pre-menopausal controls, and most of the postmenopausal women showed android type of obesity with no subject in the tertile with least WHR. It was noted that the TC/HDL-C ratio increased in direct proportion with the increase in WHR and its mean value was above the desirable value in both the tertiles of postmenopausal women. The test performance characteristics of WHR showed that WHR is a sensitive and specific index for screening of high TC/HDL-c ratio

Conclusion: We conclude that WHR [at a cut-off point of 0.84] can serve as a sensitive and specific outpatient screening index to detect postmenopausal women with an elevated TC/HDL-C ratio

Effect of menopause on serum HDL-cholesterol level

There is a marked difference in the risk of coronary heart disease between men and women of reproductive age but this gap closes with advancing age. It seems likely that some factors of reproductive physiology are responsible for this. The present study was designed to evaluate the difference in HDL Cholesterol level in premenopausal and postmenopausal women in relation with change of estradiol level. Fifty premenopausal and 50 postmenopausal women were included in the study. Estradiol was estimated by radioimmuoassay while HDL-C was estimated by Kit method. There was a significant [p<0.01] decrease in the HDL-C level of the postmenopausal women [46.72'1.009] as compared with premenopausal women [63.68'1.78]. HDL-C is an independent risk factor for coronary heart disease. This study favours the view that decrease in estradiol level and associated decrease in HDL-C seen in postmenopausal women may be responsible for the increased risk of coronary heart disease after menopause