Needle stick injuries among health care workers of public sector tertiary care hospitals of Karachi

To estimate the frequency of needle stick injuries [NSI] among health care workers [nurses, student nurses and paramedical staff] in public hospitals of Karachi. Cross sectional, observational. This study was conducted in three public tertiary care hospitals of Karachi, from November 2007 to January 2008. Data was collected by structured interview-based questionnaires in Urdu and English language. Questionnaire was designed to obtain information regarding demography, work experience, hepatitis vaccination status, and occurrence of needle stick injuries with associated factors. Needle stick injury that occurred in the previous month was the defined outcome. Data was entered in Epi Data and analyzed in SPSS version 15. A total of 417 health care workers participated in the study. Mean age of the participants was 24 +/- 11 years. Estimated proportion of participants with history of at least one time NSI was found in 66%. Around 13% [n=54] had one or more NSI in the previous one month at work and half of them were affected by non-sterile needle. None of them sought medical care. Almost 90% of them were not wearing gloves or taking any other protective measures at the time of injury. There can be serious consequences of needle stick injuries in public hospitals as large proportion of injuries involve non-sterile used needles and health care workers do not take appropriate measures of protection

Factors associated with relapsed tuberculosis in males and females: a comparative study

Tuberculosis [TB] is the leading cause of death from an infectious disease in women worldwide especially in developing countries. There is limited number of literature available on factors associated with the relapse of TB and very few studies on gender differences in this regard. This study aimed to compare the factors associated with the relapse of TB in males and females. A cross-sectional study was conducted in the medical department of Civil Hospital in Hyderabad from August 2008 to November 2008. A total of 100 consecutive patients of any age or gender, diagnosed with relapse of TB who had positive sputum smear after completion of a standard course of anti-tuberculosis therapy [ATT] were included in this study. Those with newly diagnosed tuberculosis and cases of treatment failure or treatment defaulters were excluded from the study. Demographic variables, factors associated with the previous TB infection and underlying medical conditions were among the variables compared in both sexes. The mean age of patients was 36.84 +/- 17.40 years in males and 36.21 +/- 16.41 years in females. There were 38 females and 62 males. Among the factors associated with the relapse of TB, there were statistically significant differences between males and females in regard to addiction [p=0.01], employment [p<0.001], weight gain [p=0.01] and mean hemoglobin value [p=0.05]. Further studies with larger sample sizes are required for evaluation and comparison of factors associated with the reactivation of TB in males and females. This would provide solutions for TB control agencies in the future

Primary percutaneous coronary aspiration of thrombus from infarct related artery

We are reporting the case of a 48-year-old man hypertensive, and smoker presenting with acute inferoposterior ST elevation myocardial infarction [STEMI] with right ventricular infarction. He underwent diagnostic angiogram which revealed total occlusion of mid right coronary artery [RCA] by thrombus. Multiple runs of aspiration were performed using Export Aspiration Catheter-6F and thrombus was aspirated from RCA. Postaspiration stenting was deferred due to absence of any significant obstructive lesion. Some thrombus had migrated to distal right posteriolateral branch [RPLB]. He was started on glycoprotein [GP] IIb IIIa inhibitors which had to stopped after a few hours due to upper gastrointestinal bleed. After 48 hours a re-look angiogram demonstrated good flow in RCA with resolution of the residual thrombus

Role of serum troponin-l in identifying left ventricular ejection fraction of

To determine the serum levels of troponin-l in identifying left ventricular ejection fraction [LVEF] of 63.5 ng/ml predicted LVEF of <40% with a sensitivity of 94% and specificity of 97% in patients receiving streptokinase, whereas in patients undergoing primary PCI, troponin-l levels of > 87.5 ng/ml predicted LVEF < /=40% with a sensitivity of 86% and specificity of 100%. Troponin-l concentration of > 63.5 ng/ml and > 87.5 ng/ml can predict LVEF