Validity of bispectral index in diagnosis of mild and moderate head injury

Objective: The objective of the study is to determine the validity of bispectral in diagnosis of mild and moderate head injury keeping GCS as a gold standard. Study Design: A cross sectional validation study. Place and Duration of Study: This Study was conducted in main Intensive Care Unit of the Combined Military Hospital Rawalpindi and was carried out over eight months from Dec 2009 to Aug 2010

Material and Methods: A minimum of 137 patients were included in study. At the time of admission, Glasgow coma score was calculated by 3 different anesthetists and mean was calculated. At the same time BIS reading was taken using Aspect BIS monitor

Results: Mean age of the patients was 29.5 +/- 6.2. 108 [78.8%] patients were male while 29 [29.2%] patients were female. Mean glasgow coma score was 12.2 +/- 0.9 and mean bispectral index score was 69.9 +/- 8.4. A 2 x 2 table was made between GCS and BIS. Sensitivity was found to be 95.65%, specificity 98.53%, positive predictive value 98.50% and negative predictive value 95.7%. ROC curve was drawn and demonstrated area under curve value of 0.999

Conclusion: BIS monitor can prove to be a useful adjunct in the diagnosis and management of mild and moderate head injury patients in the intensive care units

Breast cancer: clinical and histopathological features at combined military hospital Rawalpindi

Objective: This study was aimed to evaluate the various clinical and histopathological features of carcinoma of breast in the surgical unit of Combined Military Hospital [CMH] Rawalpindi in an attempt to appraise about the pattern of disease in this setting

Study Design: Descriptive cross sectional study

Place and Duration of Study: The study was conducted from September 2013 to August 2015 in surgical unit of CMH, Rawalpindi, Pakistan

Material and Methods: A total of 446 female patients diagnosed with carcinoma breast in surgical unit CMH during 2 years were included in this study. Patient's age, clinical examination and histopathological findings were recorded

Results: Among the 446 female patients, 269 patients [60.3%] presented in an age group between 40-49 years making it the most common age group. About 393 patients [88.1%] had the tumor size more than 2 cm. The commonest quadrant involved was upper outer quadrant [n=236; 52.9%]. Axillary lymph nodes were positive in 76.0% [n=339] of patients. Most common type of carcinoma was invasive ductal carcinoma in 336 patients [75.3%]. The disease was left sided in 249 cases. The most common was stage III [n=200] and grade II [n=289] carcinoma

Conclusion: In our settings the breast cancer is affecting the middle age group more commonly with upper outer quadrant being the commonest site and invasive ductal carcinoma being the commonest variant. The majority of patients presented in the later stages of disease with a moderate grade, more common lymph node metastasis and a size larger than 2 cm