RESUMO
Abstract Particulate matter (PM) is a major air pollutant causing serious health problems. The aim of the present study was to find out concentration of PM in ambient air and its associated health risk in Haripur city, Pakistan. Twenty-three samples were taken at various educational institutes, hospitals, recreational areas and industries in Haripur city. Concentration of PM2.5 (µg/m3) and PM10 (µg/m3) was measured with Youngteng YT-HPC 3000A portable PM counter. The results revealed that values of both PM2.5 and PM10 were above the permissible limits (35 µg/m3 for PM2.5 and 150 µg/m3 for PM10) set by Environmental Protection Agency Pakistan (Pak-EPA) in all the educational institutes, hospitals, recreational areas and industries investigated. Furthermore, significant (p 0.05) variation was found in the concentration of both PM2.5 and PM10 in all the educational institutes, hospitals, recreational areas, and industries studied. The concentration of PM2.5 was positively correlated with the concentration of PM10 in all the sampling sites. Therefore, from 1-14 scale standard of health index, the values of PM2.5 and PM10 exhibited that the ambient air quality of Haripur city Pakistan is under high risk. If the regulatory authorities such as Environmental Protection Agency, Health Department and Local Government monitor PM pollution in different settings of Haripur city, then a decrease can be possible in the pollution level. The remedies that can be taken to overcome the problem of ambient air pollution such as PM are plantation of trees at the sites where there are higher levels of air pollutants and use of masks on personal protection basis along with implementation of pollution control system in industries of Hattar Industrial Estate Haripur city, Pakistan.
Resumo O material particulado (MP) é um importante poluente do ar que causa sérios problemas de saúde. O objetivo do presente estudo foi descobrir a concentração de MP no ar ambiente e sua associação com o risco à saúde na cidade de Haripur, Paquistão. Vinte e três amostras foram coletadas em várias instituições de ensino, hospitais, áreas recreativas e indústrias na cidade de Haripur. A concentração de MP2,5 (µg/m3) e MP10 (µg/m3) foi medida por meio do contador de MP portátil Youngteng YT-HPC 3000A. Os resultados revelaram que os valores de MP2,5 e MP10 estavam acima dos limites permitidos (35 µg/m3 para MP2,5 e 150 µg/m3 para MP10) estabelecidos pela Agência de Proteção Ambiental do Paquistão (Pak-EPA) em todas as instituições de ensino, hospitais, áreas recreativas e indústrias investigadas. Além disso, foi encontrada variação significativa (p 0,05) na concentração de MP2,5 e MP10 em todos os locais estudados. A concentração de MP2,5 correlacionou-se positivamente com a concentração de MP10 em todos os locais de amostragem. Portanto, a partir da escala padrão 1-14 do índice de saúde, os valores de MP2,5 e MP10 mostraram que a qualidade do ar ambiente na cidade de Haripur, Paquistão, está sob alto risco. Se as autoridades reguladoras, como a Pak-EPA, o Departamento de Saúde e o governo local, monitorarem a poluição por MP em diferentes configurações da cidade de Haripur, pode ser que haja uma diminuição no nível de poluição. As medidas que podem ser tomadas para superar o problema da poluição do ar ambiente, como o MP, são o plantio de árvores nos locais onde há maiores níveis de poluentes atmosféricos, o uso de máscaras e a implantação de sistema de controle de poluição nas propriedades industriais de Hattar, na cidade Haripur, Paquistão.
RESUMO
Particulate matter (PM) is a major air pollutant causing serious health problems. The aim of the present study was to find out concentration of PM in ambient air and its associated health risk in Haripur city, Pakistan. Twenty-three samples were taken at various educational institutes, hospitals, recreational areas and industries in Haripur city. Concentration of PM2.5 (µg/m3) and PM10 (µg/m3) was measured with Youngteng YT-HPC 3000A portable PM counter. The results revealed that values of both PM2.5 and PM10 were above the permissible limits (35 µg/m3 for PM2.5 and 150 µg/m3 for PM10) set by Environmental Protection Agency Pakistan (Pak-EPA) in all the educational institutes, hospitals, recreational areas and industries investigated. Furthermore, significant (p<0.05) variation was found in the concentration of both PM2.5 and PM10 in all the educational institutes, hospitals, recreational areas, and industries studied. The concentration of PM2.5 was positively correlated with the concentration of PM10 in all the sampling sites. Therefore, from 1-14 scale standard of health index, the values of PM2.5 and PM10 exhibited that the ambient air quality of Haripur city Pakistan is under high risk. If the regulatory authorities such as Environmental Protection Agency, Health Department and Local Government monitor PM pollution in different settings of Haripur city, then a decrease can be possible in the pollution level. The remedies that can be taken to overcome the problem of ambient air pollution such as PM are plantation of trees at the sites where there are higher levels of air pollutants and use of masks on personal protection basis along with implementation of pollution control system in industries of Hattar Industrial Estate Haripur city, Pakistan.
O material particulado (MP) é um importante poluente do ar que causa sérios problemas de saúde. O objetivo do presente estudo foi descobrir a concentração de MP no ar ambiente e sua associação com o risco à saúde na cidade de Haripur, Paquistão. Vinte e três amostras foram coletadas em várias instituições de ensino, hospitais, áreas recreativas e indústrias na cidade de Haripur. A concentração de MP2,5 (µg/m3) e MP10 (µg/m3) foi medida por meio do contador de MP portátil Youngteng YT-HPC 3000A. Os resultados revelaram que os valores de MP2,5 e MP10 estavam acima dos limites permitidos (35 µg/m3 para MP2,5 e 150 µg/m3 para MP10) estabelecidos pela Agência de Proteção Ambiental do Paquistão (Pak-EPA) em todas as instituições de ensino, hospitais, áreas recreativas e indústrias investigadas. Além disso, foi encontrada variação significativa (p < 0,05) na concentração de MP2,5 e MP10 em todos os locais estudados. A concentração de MP2,5 correlacionou-se positivamente com a concentração de MP10 em todos os locais de amostragem. Portanto, a partir da escala padrão 1-14 do índice de saúde, os valores de MP2,5 e MP10 mostraram que a qualidade do ar ambiente na cidade de Haripur, Paquistão, está sob alto risco. Se as autoridades reguladoras, como a Pak-EPA, o Departamento de Saúde e o governo local, monitorarem a poluição por MP em diferentes configurações da cidade de Haripur, pode ser que haja uma diminuição no nível de poluição. As medidas que podem ser tomadas para superar o problema da poluição do ar ambiente, como o MP, são o plantio de árvores nos locais onde há maiores níveis de poluentes atmosféricos, o uso de máscaras e a implantação de sistema de controle de poluição nas propriedades industriais de Hattar, na cidade Haripur, Paquistão.
Assuntos
Risco à Saúde Humana , Poluentes Atmosféricos , Poluição do Ar , Material Particulado , PaquistãoRESUMO
The bezoar is the accumulation of undigestible food or fibre in the digestive tract, most commonly in stomach and proximal small bowel. Trichobezoar is an accumulation of hair. They may present as an independent mass in small bowel or with or without an extension into the small bowel. The trichobezoars are well described, in terms of surgical, diagnostic, and therapeutic procedures. However, there are very few reports on psychiatric literature and a dual presentation of gastric and ileal trichobezoars. The authors present a case report of a gastric with an ileal trichobezoar that is rarely reported in literature. A young girl with a history of trichophagia presented with features of small bowel obstruction. On physical examination, there was abdominal distension with a huge mobile mass on left side of umbilicus extending up to the epigestrium. There were dilated small bowel loops on abdominal radiograph. Ultrasound-abdomen also showed fluid-filled dilated small bowel loops. She was further investigated with CT scan abdomen, which showed a large mass occupying whole of the stomach and another mass in distal ileum causing small bowel obstruction, suggestive of trichobezoar. Through anterior wall gastrotomy, huge trichobezoar was removed from stomach; and through distal ileal entrotomy, ileal trichobezoar was removed
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Objectives: To understand and catalogue the specific determinants of this alarming rate of malnutrition among children of Tharparkar district, Sindh Pakistan
Methods: This was a hospital based analytical survey. Data was collected through a semi-structured questionnaire by interviewing mothers of the children [age 6-59 months], admitted in the hospital. Following WHO guidelines, weight and length/ height of 105 children were recorded. Study was conducted in District Headquarters Hospital, Tharparkar district of Sindh province
Results: Almost 48% children admitted in the hospital were identified with severe acute malnutrition. More males [55%] were malnourished as compared to females [45%]. Maternal education, household income, family size, breastfeeding, vaccination status, and frequent infections were found to be significantly associated with the severe acute malnutrition
Conclusion: Specific interventions on promoting exclusive breastfeeding, vaccination, and timely health care seeking behaviors would definitely improve the outcomes. Nevertheless, sector wide approaches would be needed on girls' education, poverty, and food security in the district in order to address the issue of malnutrition
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Objective: To determine the in vitro susceptibility of MRSA clinical isolates to ceftaroline, using interpretation of zones of inhibition by disk diffusion method. Study Design: Descriptive cross sectional. Place and Duration of Study: The study was carried out at the Department of Microbiology, Combined Military Hospital Peshawar, from Jan to Dec 2014
Material and Methods: To carry out this descriptive cross sectional study, clinical specimens were obtained from indoor and outdoor patients of Combined Military Hospital Peshawar. All the isolates of MRSA cultured with CLSI guidelines and identified with standard microbiological procedures, from clinical specimens of pus, body fluid, urine, tissue and blood were included in the study. The antimicrobial susceptibility pattern of ceftaroline was determined according to CLSI guidelines. The data was analyzed in SPSS [version 19] software
Results: Out of a total 190 MRSA isolates, 183 [96.3%] were susceptible to ceftaroline in vitro, whereas 5 [2.6%] were resistant and 2 [1.1%] were intermediate in their response to ceftaroline
Conclusion: Ceftaroline can be used effectively against infections caused by MRSA as it has shown very high in vitro activity against MRSA strains of clinical origin
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in patients undergoing regular hemodialysis [HD] due to end-stage renal disease [ESRD]
Study Design: Cross-sectional analytical study
Place and Duration of Study: Nephrology Department, Lahore General Hospital, Pakistan, from July to December 2016
Methodology: Fifty patients with end-stage renal disease. Various parameters, including the pulmonary arterial systolic pressure [PASP], were recorded. Pulmonary arterial pressure greater than 25 mmHg at rest was defined as pulmonary hypertension. It was further divided into three sub categories as mild [25-40 mmHg], moderate [40-55 mmHg], and severe [greater than 55 mmHg]. Data were correlated with age, gender, body mass index, systemic hypertension, diabetes, duration of dialysis, and Hb [hemoglobin] concentration. Data was analysed using SPSS version 23.0
Results: The median [IQR] duration of dialysis was 12 [11.25] months. Eighteen [36%] patients were found to have PH.It is greater in patients who had been on dialysis for more than 5 months. A positive association was seen between the duration of dialysis and the prevalence of PH [p=0.024]
Conclusion: A considerable number of patients on hemodialysis have pulmonary hypertension which is associated with the longer duration of maintenance hemodialysis
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Objective: To determine the frequency of awareness in mothers about the risk factors of asthma in children aged 1-12 years, attending pediatric department, Combined Military Hospital, Quetta
Study Design: Descriptive, cross sectional study
Place and Duration of Study: The study was conducted at department of Pediatrics, Combined Military Hospital Quetta. Duration of the study was six months from Oct 2011 to Apr 2012
Material and Methods: All the mothers of children with asthma were selected for this study. Informed consent was taken from all the patient's parents participated in the study. Every patient was assigned a serial number. Detailed history about risk factors was taken by the researcher and all the information entered in the proforma and collected data was analyzed by SPSS version 22
Results: Total 150 mothers were included in study. There were 9 [6.0 percent] mothers who had awareness of any relation between breast feed and the risk of asthma in children, 15 [10 percent] mother had awareness of relation between pet animals/birds and the risk of asthma in children, 3 [2 percent] mothers had awareness of relation between carpets at home and the risk of asthma, 24 [16 percent] mothers had awareness of relation between cigarette smoke and the risk of asthma in children. There were 15 [10 percent] mothers who had awareness about relation between food and the risk of asthma, 3 [2 percent] mother had awareness of relation between repeated use of medicines in children under six months of age and the risk of asthma, 5 [3.3 percent] mothers had awareness of relation between the use of pillows and the risk of asthma, 3 [2 percent] mothers had awareness of relation between the presence of cockroaches in child's bedroom and the risk of asthma in children
Conclusion: In Quetta region, mothers had lower frequency of awareness among mothers regarding pediatric [1-12 years] asthma development and its associated risk factors
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Objective: To determine the agreement between ultrasonography and nerve conduction studies in the assessment of severity of carpal tunnel syndrome
Study Design: Cross sectional descriptive study
Place and Duration of Study: Conducted at Radiology Department Combined Military Hospital Lahore, from Aug 2014 to Feb 2015
Material and Methods: Cases were selected from the Rehabilitation Medicine OPD of Combined Military Hospital Lahore. Total 130 cases of NCS positive carpal tunnel syndrome were included in the study selected on non probability convenience sampling technique. Ultrasound of wrist was conducted and results compared with nerve conduction study findings. Measurements were taken for the median nerve at the carpal tunnel inlet proximally. Patients were distributed in mild, moderate and severe grades according to ultrasound and nerve conduction studies. Agreement was determined using statistical analysis. Data entry and analysis was done by using SPSS version 20
Results: The average percentage of agreement between Ultrasound wrist and nerve conduction studies for assessment of severity of carpel tunnel syndrome is 63.4 percent.
Conclusion: Ultrasound is an additional noninvasive modality for assessment of severity of carpal tunnel syndrome having results comparable to nerve conduction studies
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Objective: To find the outcome of lateral duodenojejunostomy for larger duodenal defects due to different surgical conditions
Study design: Case series
Methodology: The clinical records were traced from the unit and hospital clinical record room. The data was collected and analyzed for the outcome of the procedure
Results: A total of six patients were managed with the surgical technique. All patients were allowed oral sips on 3[rd] postoperative day. One patient out of six needed ICU care of 42 days. Patient stay in ICU was of 42 days. Postoperative complications including anastomosis leak occurred in one patient. Nausea and vomiting was reported in two and wound infection in two patients. Mean hospital stay of the patients was 16.67 days
Conclusion: Roux-en Y duodenojejunostomy is a safe technique for the reconstruction of larger duodenal defects involving >50% [2/3[rd]] of the duodenal circumference
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Objective: To determine, the susceptibility pattern of carbapenamase producing enterobacteriaceae [CPE] against polymyxinB, tigecycline and fosfomycin
Study Design: Descriptive cross sectional
Place and Duration of Study: The study was carried out in the Department of Microbiology PNS Shifa Karachi, from 26 Sep 2013 to 25 Mar 2014
Material and Methods: All specimens were inoculated on blood and macConkey agar, incubated aerobically at 35degreeC - 37degreeC for 18 to 24 hours. After identification of gram negative rods by colony morphology, Gram's staining and biochemical reactions, these were screened for Carbapenems resistance with imipenem and meropenem 10 microg discs along with routine first and second line antibiotics by Kirby-Bauer disc diffusion technique according to Clinical Laboratory Standard Institute [CLSI] guide lines. All isolated CPE were saved and then inoculated on Mueller-Hinton agar [MHA]. Antimicrobial susceptibility against polymyxin B, Tigecycline and Fosfomycin was done by Kirby-Bauer disc diffusion method using disc polymyxin B 300 units, Tigecycline 15microg and Fosfomycin 200microg. Zone diameters greater than 24 mm were taken as sensitive for Tigecycline 15microg, 16mm for Fosfomycin 200 microg and 12 mm for polymyxin B 300 units
Results: Clinical specimens of 171 patients who fulfilled the inclusion criteria were included in our study. Mean +/- SD of age was 42.02 +/- 22.367 with C.I [38.65 - 45.40]. Out of 171 patients 110 [64%] were male and 61 [36%] were female. In vitro susceptibility results revealed that all the 171 [100%] CPE isolates susceptible to PolymyxinB, while susceptibility against Fosfomycin and Tigecycline was 132 [77%] and 49 [29%] respectively
Conclusion: CPE were found to be 100% susceptible to polymyxinB, while for Fosfomycin and Tigecycline susceptibility was 77% and 29% respectively
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Objective: To determine the frequency of hyperthermia in acute ischemic stroke patients visiting a tertiary care hospital in a developing country
Study Design: Cross-sectional, observational study
Place and Duration of Study: Medical Wards of Civil Hospital, Karachi, from January to June 2013
Methodology: Patients aged > 18 years of either gender with acute ischemic stroke presenting within 24 hours of onset of symptoms were included. Written informed consent was obtained from all participants as well as approval of ethical review committee of the institute. Axillary temperature by mercury thermometer was monitored at the time of admission and after every 6 hours for 3 days. The data was analyzed using SPSS version 17.0 [SPSS Inc., IL, Chicago, USA]
Results: A total of 106 patients of ischemic stroke were included. The mean age of enrolled participants was 60.1 +/- 9.5 years. Among these, 61 [57.5%] were males and 45 [42.5%] females. Among all patients, 51.9% presented with loss of consciousness, 30.2% with slurred speech, 77.4% with limb weakness, and 9.4% with decrease vision. A total of 17 [16%] patients with ischemic stroke developed hyperthermia. When the prevalence of hyperthermia was stratified according to age, among patients of < 60 years of age, 26% developed hyperthermia compared to 7.1% in patients of > 60 years of age [p=0.008]. On gender stratification, among male patients, 14.8% developed hyperthermia compared to 17.8% in female patients [p=0.43]
Conclusion: It is concluded from this study that the frequency of hyperthermia in ischemic stroke was 16% and it should be looked for as it has significant impact on the outcome. The hyperthermia was significantly more common in younger adults as compared to older adults. However, gender had no influence on the prevalence rate of hyperthermia
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Objective: To report on our experience of cholecystectomy associated bile duct injuries and observe factors influencing outcomes
Study Design: Simple descriptive study
Place and Duration of Study: Surgical unit IV, Military Hospital [MH] Rawalpindi, over a period of seven years from 01-01-2005 to 1-12-2012
Material and Methods: Eighty eight patients who underwent repair of bile duct injuries during this period were included in this study. Patients referred from class 'W and 'C' hospitals to our institute were also included
Results: Fifteen immediate repairs [0-72 hours] post cholecystectomy, forty eight intermediate repairs [72hrs-6wks] and twenty five late repairs [> 6 wks] were performed [table-1]. Short term morbidity was higher in patients with upper biliary tract injury [p=.04].The most common long-term complication was biliary stricture, which occurred in 28 patients [31.8%]. Patients with bile duct injuries [BDIs] repaired in intermediate period were more prone to develop stricture of biliary tree than those repaired in immediate or late period [p=.03] [table 3]. Long term morbidity was also higher in patients who presented with bile contamination of peritoneum [p=.03] and had sustained complex biliary tract injuries [E4/E5] [p=.03].The overall morbidity and mortality rate was 31% and 3% respectively
Conclusion: We observed that complex hilar injury, presence of intra-abdominal bile and timing of BDI repair is an important predictor of long-term outcome. Injuries repaired in early [0-72hrs] or late period [>6wks] were less likely to develop biliary stricture as compared to injuries repaired in intermediate period [72hrs-6wks]. Moreover complex hilar injuries and intra-abdominal bile at presentation increases the possibility for development of late biliary stricture
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Colecistectomia , Complicações Pós-Operatórias , Morbidade , Estudos RetrospectivosRESUMO
Objectives: To understand women and healthcare providers’ perceptions, and to investigate the cultural and behavioural factors influencing the use of antenatal IFA supplements in rural and urban settings of Pakistan. Methods: Focus group discussions and in-depth interviews with mothers, currently pregnant women, community health workers and doctors were conducted in rural and urban areas of two districts of Pakistan. Data was collected between August and November 2012. Results: The majority of women were aware of the perceived benefits of antenatal IFA supplements. The facilitating factors for the women’s use of supplements were: they had knowledge of benefits; they had trust in the healthcare providers; the supplements were available; they had the financial capacity to buy them; they felt better after taking these supplements; and they received support from family members. The barriers to the women’s use of supplements were: they forgot to take them; the non-availability of supplements; their limited financial capacity to buy them; the lack of antenatal care services; family members not allowing use of the supplements; not knowing about the benefits or no education; fear or experience of side effects; considering them as contraceptives; and felt better thus stopped. Conclusions: The coverage of antenatal IFA supplementation can be improved by reducing the barriers related to the use of antenatal IFA supplementation in Pakistan. Interventions focused on providing adequate awareness, good quality counselling, reminder messages, availability of free supplements throughout pregnancy and reducing the side effects should be developed and implemented.
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To observe the perioperative morbidity and mortality rates of 100 transhiatal esophagectomies operated for esophageal carcinoma in a surgical unit of a tertiary care hospital. Data pertaining to all patients that had undergone transhiatal esophagectomy from Feb, 2012 to Jan, 2014 were reviewed. The study group comprised 100 patients. Indication for surgery was esophageal cancer. Perioperative morbidity and mortality i.e. morbidity and mortality during the first 30 days, were studied. Two patients died during the postoperative period in hospital. The anastomotic leakage rate was zero. No dysphagia was found during one month of postoperative period. Overall survival was 98% for the first 30 days of surgery. Transhiatal esophagectomy has been common stay and a safe rather feasible procedure. Oncological therapy has its role and better results are found in centers where the procedure is frequently performed
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Objectives: To identify the frequency of common birthmarks presenting in outpatients department of dermatology until and to increase awareness among doctor about the common phenomena
Patients and Study Design: A cross sectional study
Setting: OPD of Dermatology department of Dow University Hospital
Period: January 2014 till October 2014
Methods: During a year, by using non-probability convenient sampling only 100 patients of both genders were enrolled in the study after ensuring inclusion, exclusion criteria. Complete history was recorded and a thorough general physical and cutaneous examination was performed. Information was collected on predesigned questionnaire after taking informed consent. Data Analysis was carried out on SPSS statistics software
Results: Out of 100 patients, 43% were males and 57% were females. In 69.6% patients, the birthmarks were noticed around time of delivery, 28.3% patients were noticed within 1[st] year of life and 2.2% later in 5 year. Pigmented birthmarks were identified in 65.2% patients while 34.8 % have vascular birthmarks.71.1% had no changes in color during life span. While 37.8% had 1-3 cms birthmark and 45.7% have reported an increase in birthmark
Conclusions: We found birthmarks benign; they may grow with age but they do not need treatment unless there is concern either cosmetically or they have pain and discharge
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Lactente , Pacientes Ambulatoriais , Centros de Atenção Terciária , Conscientização , Estudos Transversais , Nevo PigmentadoRESUMO
The objective is to observe relationship between low serum magnesium level and Migraine. Prospective Observational. This study was conducted in Dow University Hospital, Dow University of Health Sciences, Karachi from 1[st] January 2013 to 31[st] December 2014. One hundred and fifty patients attending the medical and Neurology OPD at Dow University Hospital were included in study. They were diagnosed according to International Headache Society [HIS] criteria for migraine headache. 150 patients were enrolled in study 49 [32.7%] were male and 101 [67.3%] were female patients mean age was 28 [ +/- 6.2] years, After excluding other causes migraine was diagnosed in 102 [68%] patients. Out of 102 patients 71 [69.7%] were have low serum magnesium level. In the remaining patients with non migrainous headache, only 6 patients [12.5%] have low serum magnesium level because of some other causes for example medications. Migraine is frequently associated with Serum low level of Magnesium compare to patient with nonmigrainous headache
Assuntos
Humanos , Masculino , Feminino , Adulto , Cefaleia , Transtornos de EnxaquecaRESUMO
Appendicular mucocele is rare. Clinical presentation is varied with more than half being asymptomatic. Patients may present with clinical symptoms suggestive of [acute appendicitis] or other non specific abdominal complaints. A case having pain in the right lower abdomen diagnosed as retrocecal mucocele of appendix on imaging studies. Surgery revealed a giant retrocecal mucocele measuring 14 cm in length and 4 cm in diameter. The final pathologic diagnosis was mucocele caused by mucinous cyst adenoma
Assuntos
Humanos , Pessoa de Meia-Idade , Feminino , Apêndice , Neoplasias do ApêndiceRESUMO
To determine the etiological spectrum of acute intestinal obstruction in our clinical setup Military Hospital Rawalpindi. Descriptive study. Surgical department of Military Hospital, Rawalpindi from Jul 2012 to Jul 2013, over a period of about 1 year. A total of 120 patients with acute mechanical intestinal obstruction who underwent laparotomy were included in our study while those with non-mechanical intestinal obstruction like history of trauma and paralytic ileus were excluded from the study. All the patients were selected by non-probability purposive sampling technique. Emergency laparotomy was done and operative findings were recorded. A total of 120 patients with mechanical intestinal obstruction were included in this study out of which 93 [69.17%] were female and remaining 27 [30.83%] were males. Male to female ratio was 1:2.24. Age range of patients was 22-85 years. Out of 120 patients operated for acute intestinal obstruction post-op adhesions were found in 37 [30.83%] patients followed by intestinal tuberculosis in 23 [19.17%] patients, obstructed inguinal hernias in 13 [10.83%], gut malignancies in 15 [12.5%], Meckel's diverticulum with bands in 7 [5.83%], volvulus in 7 [5.83%], perforated appendix in 6 [5%], intussusception in 2 [1.7%], inflammatory bands in 5 [4.17%], trichobezoar and faecal impaction in 2 [1.7%] while in 3 [2.5%] patients no definite cause was found. Post-op adhesions are the commonest cause of mechanical intestinal obstruction in our setup followed by intestinal tuberculosis as second most common clinical pattern of presentation
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To evaluate the presence of intrinsic factor antibody in vitamin B12 deficient patients. Cross-sectional, observational study. Fauji Foundation Hospital, Foundation University Medical College and Armed Forces Institute of Pathology, Rawalpindi, from January 2011 to June 2012. A total of 120 patients of megaloblastic anaemia were selected on the basis of low serum vitamin B12 level. The intrinsic factor antibody tests were performed by ELISA method. The patients were considered positive or negative on the basis of presence or absence of intrinsic factor antibody respectively. The data was analyzed by using SPSS version 14. Pernicious anaemia with intrinsic factor deficiency was found in 13.3% in 120 vitamin B12 deficient patients. The mean age of patients of pernicious anaemia was 41.5 years, with a male to female ratio of 1:2.5. It was relatively more common in older age [17% in age more than 60 years] as compared to other age groups. Frequency of pernicious anaemia in megaloblastic anaemia was 13.3%. The male to female ratio was 1:2.5 and it was relatively more common in age group of more than 60 years