Incidence of retinopathy in chronic Hepatitis C patientstreated with pegylated interferon alpha 2a and ribavirin combination therapy

The objective of this study was to determine the incidence of retinopathy in chronic hepatitis C patients treated with Pegylated interferon alpha 2a and Ribavirin. This descriptive case series study was conducted in Medical Unit II of the Jinnah Hospital Lahore from September 2012 to February 2013. One hundred chronic hepatitis C patients visiting Medical Unit II outpatient department fulfilling inclusion criteria were selected for this study via non probability purposive sampling. Patients were started on pegylated interferon and ribavirin combination therapy. Subjects were subjected to dilated eye fundoscopic examination at the start of therapy and then after three months of the therapy. One hundred patients were included in this study. Out of these 100 patients 5% developed retinopathy whereas fundus examination was normal in rest of the patients. Interferon therapy can lead to retinopathy. Periodic fundoscopic examinations help in early detection and prevent progression to permanent visual loss

Treatment of fractures in 15 cases of osteitis fibrosa cystica - hyperparathyroidism: a case series

To study retrospectively the results of treatment of cases of pathological fractures presenting with osteitis fibrosa cystica due to hyperparathyroidism. Records of cases of hyperparathyroidism treated for pathological fractures in the past seven years were reviewed to assess success of treatment by various modalities. All patients had been investigated for vitamin D deficiency, parathyroid levels, serum calcium and phosphate levels along with renal function tests. All X-rays were restudied for evidence of osteitis fibrosa cystica. Thirteen cases healed uneventfully, one died of unrelated reasons and one failure led to non union. All patients had received oral calcium supplements and injectable vitamin D for three months at least. There were no complications of this treatment regimen. Pathological fractures due to bone weakness caused by hyperparathyroidism can be treated by various treatment modalities supplemented by oral calcium and injectable vitamin D

Communication skills of specialist doctors: assessment with SKAF scale a new tool

To evaluate the standards and uses of communication skills of specialist doctors during the doctor-patient interactions among a sample of specialists belonging to various specialities and based at different hospitals of Lahore. One hundred specialists were asked to participate in the prospective, questionnaire based survey in Lahore. These volunteers were asked to fill a form keeping in view their current practices. The scores thus achieved were measured using a proposed SKAF score. The results were graded into four parts depending upon the score achieved by the subjects. Twelve people never returned the survey instrument. Of those who did majority scored as good or excellent. Females showed a better score than males. Those who had previously been instructed formally did better on the SKAF scale. The need of formal hands on training workshops on Communication Skills in both under graduate as well as post graduate trainees cannot be reiterated

Granulocytic sarcoma presenting as a bone tumor

Granulocytic sarcomas [chloromas] are very rare tumors that occur outside hematopoietic areas, it consists of primitive granulocytic cells. They arise de novo, or may be associated with other hematologic disorders such as acute myeloid leukemia, myelodysplastic syndrome, or myeloproliferative disorders. We report here a case of a 32-year-old man who presented with drowsiness, paraplegia, fever and bone pains for the last 3 months. There was equivocal evidence for caries spine in clinical history, examination and upon routine investigations. X-rays and MRI spine showed anterior wedge fractures of D[10] and L[1]. Technetium bone scan pointed to hot areas in the pelvis and spine. The biopsy taken from right Iliac crest showed it to be a granulocytic sarcoma. Bone marrow examination showed a normal picture