Prevalence of hepatitis B and hepatitis C in blood donors of Karachi

Hepatitis B virus [HBV] and Hepatitis C virus [HCV] are two major public health problems in the country. The purpose of this study was to compare the prevalence of hepatitis B and hepatitis C in voluntary non-remunerated and replacement donors in Baqai Medical University Hospital and PNS Shifa Karachi from April, 2005 to June, 2007. A total of 11459 donors were bled. Anti-HCV was found positive in 237 [2.068%] HBs Ag was positive in 196 [1.71%] and both were positive in 11 [0.095%] individuals. This study shows a higher prevalence of HCV than HBV infection in blood donors. The prevalence of HCV and HBV can be minimized by the screening of all donors for anti-HCV and HBs Ag and discouraging the use of unsterilized syringes

Prevalence, clinical predictors and diagnosis of gastro-oesophageal reflux in children with persistent respiratory symptoms

OBJECTIVES: This was a cross sectional study conducted in the Paediatric Institute among infants and children with chronic respiratory symptoms with the following objectives: i) to determine the prevalence of gastro-oesophageal reflux in children with persistent respiratory symptoms, ii) to identify the clinical predictors of GOR (Gastro-oesophageal reflux) in children with persistent respiratory symptoms and iii) assess the validity of abdominal ultrasound, barium oesophagogram and chest radiograph in diagnosing GOR in these patients. MATERIALS AND METHODS: Forty-four patients were recruited over a period of six months. All the presenting symptoms were identified. The patients were subjected to chest radiograph, abdominal ultrasound, barium oesophagogram and 24-hour pH oesophageal monitoring. The predictive validity of clinical symptoms, chest radiograph, abdominal ultrasound and barium oesophagogram were assessed. Twenty-four hours oesophageal pH was the gold standard to diagnose GOR. RESULTS: The mean age of patients was 9.1 months (1-58 months). Thirty-one patients (70.5%) were confirmed to have GOR by pH study. Respiratory symptoms alone were not useful to predict GOR. Cough had the highest sensitivity of 51.6%. Stridor, wheeze and choking each had a specificity of 76%. Wheeze, vomiting, choking and stridor were identified to have high specificity (90-100%) in diagnosing GOR when any two symptoms were taken in combination. Collapse/consolidation was the commonest radiological abnormality but had low sensitivity (35.5%) and specificity (53.8%). However hyperinflation on chest radiograph had a specificity of 92.3% with positive predictive value of 80% in diagnosing GOR. Barium oesophagogram has low sensitivity (37.9%) and moderate specificity (75%) in diagnosing GOR in children with respiratory symptoms. Abdominal ultrasound was a valid mode of diagnosing GOR when there were three or more reflux episodes demonstrated during the screening period with a specificity of 90.9%. However the sensitivity was low i.e. 20-25%. The specificity increased to 90-100% when two positive tests were taken in combination (abdominal ultrasound and barium oesophagogram). However the sensitivity remained low (10-20%). Chest radiograph did not improve the predictive value when considered with the above tests. Combination of clinical symptoms were useful as clinical predictors of GOR. In the absence of a pH oesophageal monitoring, a combination of barium oesophagogram and ultrasound may be helpful in diagnosing GOR.

Reduction in lactation failure problems at a tertiary centre without hi - tech equipment

560 mothers with breastfeeding problems were examined at Lactation Managment Clinic Sir Ganga Ram Hospital, Lahore. Details of these problems are discussed in the paper. All of these were managed by counselling and simple procedures and without Hi-Tcch equipment