Paranasal sinuses and nasal cavity; the notorious neighbours of orbit

To describe the clinical and neuro-radiological patterns of orbital invasion by the sino-nasal diseases. Descriptive, Retrospective study. 2004 to 2009. We retrospectively reviewed fifty four cases of nasal and paranasal sinus diseases invading the orbit. The medical charts were analyzed. The data considered for the study was age, sex, ocular presentation and associated systemic problems of the patients. The neuro-radiological results were correlated with the clinical picture. The age range was from 6 to 85 years [mean 45.5]. Male to female ratio was 3.5: 1. The initial clinical presentation was Proptosis [66.66%], disturbance of vision [25.9%], ophthalmoplegia [11.11%], diplopia [9.26%] and ptosis [9.26%]. 79.63% patients had inflammatory etiology and 20.4% had neoplastic lesions in the nasal and paranasal sinuses extending into the orbit

Pituitary macroadenomas; demographic, visual, and neuro-radiological patterns

To describe the demographic profile, patterns of visual disturbance and imaging studies of patients with Macroadenoma. Retrospectively. Reviewed the clinical charts and neuroradiologic imaging of 125 patients who were diagnosed as cases of Macroadenoma. 2000 to 2009. 100 patients were selected who had visual disturbances along with Macroadenomas. Age, sex, visual symptoms and other associated systemic problems of these patients were reviewed. The Neuroimaging data [Magnetic Resonance Imaging] was correlated with the clinical picture. The data was analysed using Statistical package for social sciences [SPSS]. The Descriptive statistics were calculated for age and MR findings. The age ranged from 9 to 85 years [mean 42.92]. Male to female ratio was 1.4:1.90% patients had visual disturbances including visual field defects and 10% had ocular motor nerve palsies. Tumour extension on MR studies showed optic chiasma compression in 69% patients, cavernous sinus invasion in 57% and Sphenoidal sinus invasion in 14%. Haemorrhagic foci were seen in 8% and intra tumour necrosis was found in 9% patients. The most common path for the extension of pituitary macroadenomas is towards the optic chiasma. Hence majority of these patients present with visual disturbances. MRI is an excellent aid to see the extent and invasion of Macroadenomas to the surrounding structures

Acute poisoning in children: etiological agents, risk factors and outcomes

A total of 70 patients were thus included. The patients were followed till discharge. A Proforma was filled and results were analyzed on SPSS version 10 of computer programme. All consecutive patients of poisoning who visited the Emergency Ward during the study period fulfilling inclusion criteria were enrolled. The mean age was 2.89 years with range of 6 months to 10 years. Male to female ratio was 1.5:1. Kerosene was the commonest agent accounting for 50% of all cases, followed by pharmaceutical products [14.3%] and chemicals [12.9%]. Storage of Kerosene in empty bottles of beverages and lack of proper storage of drugs were the commonest risk factors identified. Oral ingestion was the most common route of intoxication. Most of the patients [84.3%] were discharged without any sequelae. Overall mortality was 5.7%. Conclusion most of toxic substances to which children were exposed were those stored in eatable containers i.e. kerosene oil. Minority of children with accidental poisoning developed serious toxicity. Parents can prevent many of these accidents by identifying, adequately storing and locking away toxic material

Incidence of H. pylori antibodies in patients with non ulcer dyspepsia admitted in people's medical college hospital, Nawabshah

To find out incidence of H. pylori anti bodies in non ulcer dyspepsia patients admitted in people's medical college hospital, Nawabshah. A prospective study was conducted at Department of medicine, unit III peoples medical college hospital, Nawabshah from March 2003 to Oct 2004. The patients admitted in medical unit-3 in PMCH, Nawabshah with dyspeptic symptoms. Any organic disease was excluded by upper G I T endoscopy. H. pylori antibodies were done by kit method. A total of 100 patients were taken. 60% were female and 40% were male. H. pylori antibodies were positive in 45 [45%] subjects. H. Pylori is significantly positive in non-ulcer dyspepsia patients. So every patient of non ulcer dyspepsia should be evaluated for H. Pylori antibodies

evaluate the association of anthropometric indices with metabolic syndrome and insulin resistance in patients with NAFLD

To evaluate the association of anthropometric indices [body mass index and waist circumference] resistance [IR] and metabolic syndrome [MS] in patients having non-alcoholic fatty liver disease [NAFLD]. From August 2005 to Mar 2006 a case series of 70 patients with clinical and/or histological diagnosis of NAFLD were selected at the gastroenterology and Hepatology clinic of Ghurki trust teaching hospital. Liver function tests, lipid profile, glucose and insulin were checked in all patients. Body mass index [BMI] and waist circumference [WC] were determined according to WHO criteria. IR was measured by means of the homeostasis model assessment [HOMA] and IR was present in those having HOMA >/= 3. Metabolic Syndrome [MS] was defined according to the Adult Treatment Panel III [ATP III]. Liver biopsy was performed in 20 cases. Body mass index >/= 30kg/m[2] [obesity] was found in 40% of the cases and BMI 25-29.9 kg/m[2] [overweight] in 52%. BMI correlated with IR [r = 0.39; P = 0.02] and WC with ALT [r =0.02; P = 0.03] IR [p=0.01] and MS [p=0.001]. The presence of steatohepatitis with fibrosis on liver biopsy was associated with overweight BMI [72%], increase of WC [50%] and IR [18%] [p<0.05]. Conclusions: Body mass index and WC are associated with MS, IR and histological findings in patients with NAFLD

Evaluation of AST/ALT ratio in patients with liver disease

To assess AST/ALT ratio in patients with liver disease, i.e. hepatitis and cirrhosis and to evaluate its significance as predictor of cirrhosis in our population. Place and Duration of Study: The study was carried out in the Department of Medicine and Gastroentero logy Medical Unit-I Post Graduate Medical Institute/Services Hospital, Lahore and Department of Pathology PGMI Lahore Pakistan. The period of study was from July 1999 to July 2000. Subject and This study comprised 75 patients suffering from liver disease. All the patients were thoroughly examined clinically and ultrasound was performed. They were divided into two groups; Group I: It included 50 [35 male, 15 female] patients with cirrhosis of the liver confirmed clinically and by ultrasonography. Group II: It comprised of 25 [18 male, 7 female] patients with acute hepatitis confirmed by serology. The blood sample were sent to department of pathology Postgraduate Medical Institutes Lahore. HBs Ag and anti-HCV were performed using the commercially available kits based on ELISA techniques. AST and ALT were determined using the kits based on photometric methods in which the Oxo-acids are assayed by coupling with 2-4 dinitrophenyl hydrazine. The mean AST and ALT concentrations of the patients with hepatitis [Group II] were elevated significantly [P<0.001] as compared to those of the cirrhotic patients [Group I]. In contrast, the mean AST/ALT ratios of the cirrhotic patients [Group I] were elevated significantly [P<0.001] than the patients with hepatitis. Conclusions: The present study shows that the mean AST/ALT ratios of the cirrhotic patients were significantly higher [P < 0.001] as compared to those with hepatitis. Hence, the AST/ALT ratio can be considered as a dependable marker of fibrosis in patients with chronic liver disease in Pakistan, even though liver biopsy remains the most definitive diagnostic measure for cirrhosis