Intercomparison of environmental gamma doses measured with A NaI (Tl) survey meter and thermoluminescent dosimeters (TLDs) in the Poonch division of Azad Kashmir, Pakistan / 生物医学与环境科学（英文）

This study presents the intercomparison of the outdoor environmental gamma dose rates measured using a NaI (Tl) based survey meter along with thermoluminescent dosimeters (TLDs) and estimation of excess lifetime cancer risk (ELCR), for the inhabitants of Poonch division of the Azad Kashmir, Pakistan. CaF2: Dy (TLD-200) card dosimeters were installed at height of 1 m from ground at fifteen different locations covering the entire Poonch division comprising of three districts. During three distinct two month time periods within the six month study period, all the installed dosimeters were exposed to outdoor environmental gamma radiations, retrieved and read out at Radiation Dosimetry Laboratory, Health Physics Division, PINSTECH laboratory, Islamabad. The ambient outdoor gamma dose rate measurements were also taken with NaI (Tl) based portable radiometric instrument at 1 m above the ground. To estimate the annual gamma doses, NaI (Tl) based survey data were used for one complete year following the deployment of the dosimeters. The mean annual gamma dose rates measured by TLDs and survey meter were found as 1.47±0.10 and 0.862±0.003 mGy/y respectively. Taking into account a 29% outdoor occupancy factor, the annual average effective dose rate for individuals was estimated as 0.298±0.04 and 0.175±0.03 mSv/y by TLDs and survey meter, respectively. For outdoor exposure, the ELCR was calculated from the TLD and survey meter measurements. The environmental outdoor average annual effective dose obtained in present study are less than the estimated world average terrestrial and cosmic gamma ray dose rate of 0.9 mSv/y reported in UNSCEAR 2000. The possible origins of gamma doses in the area and incompatibilities of results obtained from the two different measurement techniques are also discussed.

Seasonal variation and demographical characteristics of carpal tunnel syndrome in a Pakistani population

To determine the demographic characteristics of gender, age, involvement of hand/hands and seasonal distribution in patients with a neurophysiological diagnosis of carpal tunnel syndrome [CTS]. An observational study. Department of Neurology, Fauji Foundation Hospital, Rawalpindi and PIMS, Islamabad, during December 2006 to July 2009. Cases reported in the months of December and January [winter group] and those reported in the months of June and July [summer group], of any age and gender with electrophysiological confirmation of CTS were included. Those having median neuropathy in the region of elbow, brachial plexopathy and cervical radiculopathy [C6-7] or polyneuropathy were excluded. Nerve conduction study was done in Median nerve. Statistical significance between the two groups [summer and winter] was calculated. Among the 213 patients [320 hands] of CTS, 70 [105 hands] were in summer group and 143 [215 hands] were in winter group. There were 15 [21.43%] males and 55 [78.57%] females in summer group and 22 [15.38%] males and 121 [84.62%] females in winter group. The female hands were 83 [79.05%] and 182 [84.65%] and male hands were 22 [20.95%] and 33 [15.35%], respectively in summer and winter group. Mean age was 44.38 years and 45.16 years. The right hand was affected in 64 [60.95%] and 121 [56.28%]; and the left hand was affected in 41 [39.05%] and 94 [43.72%] in summer and winter groups respectively. Half of the patients had bilateral involvement. The p-values for the NCS variables were not statistically significant. Presentation with CTS was more common in winter at the study centre. Female gender and dominant hand was affected more frequently. There were no significant changes in NCS parameters among the two groups

Hypoglycemia; a predictor of mortality in patients of hepatic failure

The objectives of the study were to find out the incidence of hypoglycemia in patients of hepatic failure belonged to fulminant variety or decompensated cirrhosis variety, to compare different variables and to study the effects of hypoglycemia in these patients on mortality. Medical Units Nishtar Hospital, Multan. September 2001 to September 2002. For this purpose, 100 hospitalized and diagnosed patients of hepatic failure were included regardless of etiology. Patients with diabetes mellitus, doubtful diagnosis and children < 12 were excluded. A RBS sample on presentation was taken and RBS < 80 mg/dl was defined as hypoglycemia. Out of 100 cases, 39 were found to have hypoglycemia and among them more were of fulminant hepatic failure variety. It was concluded that hypoglycemia was a feature of severe hepatocellular failure and blood sugar level should be checked frequently, corrected and maintained promptly. It is recommended that in future more and more details should be sought from the patients e.g. use of indigenous drugs and other co-morbid conditions coexisting at the same time so that more strong guidelines are established as a gold standard in the management of these hypoglycemic patients suffering from hepatic failure

Hypoglycemia as. a. predictor or mortality in patients of hepatic failure

To find out the incidence of hypoglycemia in patients of hepatic failure belonging to fulminant variety or decompensated cirrhosis variety, to compare different. For this purpose, 100 hospitalized and diagnosed patients of hepatic failure were included regardless of etiology. Patients with diabetes mellitus, doubtful diagnosis and children<12 were excluded. A RBS sample on presentation was taken and RBS<80 mg/dl was defined as hypoglycemia. Out of 100 cases, 39 were found to have hypoglycemia and among them more were of fulminant hepatic failure variety. It was concluded that hypoglycemia was a feature of severe hepatocellular failure and blood sugar level should be checked frequently, corrected and maintained promptly. It is recommended that in future more and more details should be sought from the patients e.g. use of indigenous drugs and other co-morbid conditions coexisting at the same time so that more strong guidelines are established as a gold standard in the management of these hypoglycemic patients suffering from hepatic failure

Validaty of siriraj Stroke scoring

To study the sensitivity and specificity of Siriraj Stroke Scoring [SSS] and to validate the accuracy of SSS in acute supratentorial stroke syndromes. Design: Noninterventional descriptive study. Place and Duration of Study: Department of Neurology, Pakistan Institute Of Medical Sciences, Islamabad, and Department of Medicine, Federal Government Services Hospital, Islamabad, from July to December 2000 and February to July 2002, respectively. Subjects and One hundred [100] consecutive cases of acute supratentorial strokes were studied in accordance with SSS and sensitivity and specificity of SSS for supratentorial infarction and haemorrhage was tested against the computerised brain scanning [CT] as a gold standard. Siriraj Stroke Scoring was applied. Patients with subarachnoid haemorrhage and transient ischemic attacks were excluded from the study. The findings were recorded, compared and statistically analyzed. Out of 100 patients 45 were male and 55 female with mean age of 59 years. Sixty-two patients had hypertension, 36 patients had one or more atheroma markers [diabetes, coronary artery disease and claudication]. Mean diastolic blood pressure was 98 mmHg with range of 60-140 mmHg and mean systolic blood pressure of 163 mmHg with the range of 90-240 mmHg. Forty-eight patients had cerebral infarction, 36 had cerebral hemorrhage while 16 were borderline cases on the basis of Siriraj stroke scoring. CT brain showed 56 and 39 patients had cerebral infarction and haemorrhage respectively while 5 of CT scans were normal. The sensitivity and specificity of SSS for cerebral infarction was 71 and 85 respectively and for intracerebral haemorrhage, it was 73 and 90 respectively. The positive predictive values of SSS for cerebral infarction and haemorrhage were 87% and 83 respectively. The siriraj stroke scoring system is a valid and specific scoring system for the diagnosis of acute supratentorial stroke and intracerebral haemorrhage