Prevalence of diabetic retinopathy in Pakistan: a systematic review

Objectives: Primary aim was to review the literature on the prevalence of diabetic retinopathy [DR] and Vision threatening diabetic retinopathy [VTDR] in Pakistan

Methods: A search of the bibliographic databases [Medline, Pub med, and Google scholar] was conducted from 1990 to March 2017. Articles about prevalence of DR and VTDR in Pakistan were retrieved and scrutinized. The studies satisfying the inclusion/exclusion criteria were considered for detail review

Results: Forty one articles on prevalence of DR were traced out. Exclusion and inclusion criteria were met in 29 studies. In selected studies [29], pooled Prevalence of DR was found to be 28.78% with a variation of 10.6% to 91.3%. Out of 29 studies, DR was classified in 19 studies. Pooled Prevalence of VTDR in these 19 studies was found to be 28.2% [variation of 4% to 46.3%] of patient with retinopathy and 8.6% of all diabetics

Conclusion: A great variation in the values of DR and VTDR was observed in this study. Researchers suggest a community based study with uniform methodology to find out a comparable value of prevalence of DR and VTDR in all provinces of Pakistan

Causes of maxillofacial injuries in patients reporting at Liaquat University Hospital Hyderabad

Objectives: To determine the causes of maxillofacial injuries in patients reporting at Dental outpatient department of Liaquat University Hospital Hyderabad

Methodology: This descriptive study was carried out from January 2014 to December 2015, at the outpatient department of Oral Surgery. Data relating to 136 patients of maxillofacial trauma was collected. The causes of trauma were asked from the patients and attendants. The diagnosis of the maxillofacial trauma was done on the basis of history, clinical findings and with the help of appropriate radiographs. All the relevant information was recorded in structured Proforma

Results: Most prevalent age of trauma was 21-30 years, male [n= 104, 76%] outnumbered the female [n=32, 24%] with ratio of 3:1.The commonest cause of maxillofacial fractures was found to be Road Traffic Accidents [RTA] in 59[43.4%] cases, followed by assault 44[32.4%], fall injuries 12[8.8%], sports injuries 11[8%] and gun shot and others in 10[7.4%]

Conclusion: Road Traffic Accidents, in this part of the country, are the most common cause of maxillofacial fractures. Vehicle's poor condition, heavy traffic load and poor condition of roads are major contributing factors. There is a clear need of continues awareness of road user about the traffic rules, road safety and compulsory seat belt for four wheel vehicle passengers and helmet legislation for front as well as back seat motorcycle passengers

To determine the effects of copper, zinc and magnesium in patients with pre-eclampsia

Objectives: Pre-eclampsia is hypertensive and multi-system related disorder of pregnancy. It has frequently labeled as "disease of theories". 5- 10% of pregnancies complicated due to pre-eclampsia and it is most common health problem worldwide. This study intended to estimates the copper, zinc and magnesium levels in patients with pre-eclampsia

Method: Total eighty subjects were included in the present study, from which 40 voluntaries were normotensive healthy pregnant women [controls], 40 were pre-eclamptic patients [cases]. The subjects were recruited having symptoms of interest after taking obstetric history, anthropometric and clinical data. After taking informed consent, blood sample collected and stored for biochemical analysis. The serum zinc, copper and magnesium levels were analyzed by Atomic Absorption Spectrophotometer. The study was conducted in biochemistry department during period of eight months from October 2015 to June 2016

Results:Total eighty subjects were included in present study. The trace elements decreased and shows significant difference between control healthy pregnant and pre-eclamptic women [p<0.05]. The mean difference of copper [0.15+/-0.07], zinc [2.94+/-0.45] and Mg[++] [0.15+/-0.09] mg/dl for the cases group and for control group copper was [0.20+/-0.03], zinc [5.11+/-0.21] and Mg[++] [2.17+/-0.21] mg/dl respectively

Conclusion: Trace elements are essential for the healthy pregnancy, suppressed concentration of serum Zinc, Copper and Magnesium may put forward the possible involvement in the pathology of pre-eclampsia. The aim of this study was to protects the mothers as well as her coming newborn from such life threating disease

Frequency and outcomes of organophosphate poisoning at tertiary care hospital in Nawabshah

Objective: This study aims to determine the frequency of organophosphate poisoning outcomes at tertiary care hospital at Nawabshah

Design: Descriptive Study

Setting: Intensive Care Unit at Peoples University of Medical and Health Sciences for Women, Nawabshah

Material and Method: A retrospective study of 387 patients of organophosphate poisoning admitted in Intensive Care Unit at Peoples University of Medical and Health Sciences for Women, Nawabshah, catering all cases from urban and rural areas, during the years January 2013 to December 2015. The Intensive Care Unit is fully equipped with all modern equipment to treat cases of poisoning. The record of the patients were reviewed and the data was entered in proforma for further analysis. The variable considered were gender, age and yearly outcome was presented as frequencies and percentage whereas age was presented as mean +/-SD

Results: A total of 387 cases organophosphate poisoning were reported in our hospital between 2013 and 2015. The age of study population in our study was 26.14 +/-10.086 years with predominance of males [62.5%]. The highest number of cases [42.1%] were reported during 2013 with the least [23.3%] in 2014. Moreover, 275 [71.1%], 105 [27.1%] and 7 [1.8%] cases were cured, expired and referred during the period of three years i.e. 2013 to 2015

Conclusion: Organophosphate poisoning cases were more common among males. Youth is predominant population for organophosphate poisoning which draws immediate attention for public health policy makers, by educating the public through print and electronic media specially television with dramatize shots

Factors causing variation in age at menarche

Background: Menarche is an important phase of female reproductive life, which with passage of time is getting earlier worldwide. Early menarche has several psychosocial and behavioral effects on a girl's teenage life, besides it increases the risk of breast cancer, therefore it is important to determine the underlying causes of this change

Objective: To assess the extent of and factors responsible for variation in age at menarche in females of Sindh

Study design: Cross-sectional, questionnaire based

Methodology: The study was conducted by department of physiology on 600 sexually healthy females, belongs to interior Sindh, Hyderabad and Karachi. Informed written consent was obtained, data about menarcheal age and relevant factor was collected using questionnaires containing close-ended questions. Volunteers were divided into three groups, each of 200, based upon their birth year, Group 1 included ladies who were born in 1970s or before, Group 2 consists those who born in 1980s while volunteer from Group 3 were the youngest generation born during 1990's and onwards

Results: Mean age at menarche for Group 1 was 13.6 yrs [Std. Dev +/- 1.3], Group 2, 13.3 yrs [Std. Dev +/- 1.0] and for Group 3 it was 12.3 yrs [Std. Dev +/- 1.1]. Pearson Correlation between age at menarche and menarcheal age of sister for all three groups was significant [P = 0.01]. Twenty-three percent volunteers in Group 1, 37% in Group 2 [P = 0.01] and 48% in Group 3 [P = 0.02] had awareness about menstruation at their time of menarche

Conclusion: Menarcheal age, over time is decreasing, among girls of Sindh, Pakistan. This may be due to pre-menarcheal awareness and hereditary influence

Radiological indicators to serve the purpose of juvenile justice system ordinance, 2000

OBJECTIVES: To document radiological age indicator for differentiating Juvenile from adult offender for the purpose of Juvenile Justice System Ordinance, 2000 of Pakistan

STUDY DESIGN: Perspective descriptive study

SETTING: Department of Radiology and Imaging, Liaquat University Hospital Jamshoro/ Hyderabad, Sindh, Pakistan

STUDY PERIOD: June 2007 to December 2008

METHOD: Radiological study of adolescents both males and females [Total 394 comprising of 145 females and 249 males] subjects studying in various academic institutions of Hyderabad, representing the heterogeneous population was conducted with an object to observe the union of various bones that can provide an age indicator of 18 years for both genders

RESULTS: X - Ray pelvis showing fusion of iliac crest with the rest of the bone and X- Ray medial end of clavicle showing appearance, represents age 18 years + 2 months in females, whereas in males X- Ray shoulder joint showing complete Epiphyso- Diphyseal union and their X- Ray pelvis still showing no fusion of iliac crest, represents same age group of 18 years+ 2 months

Radiologically female subjects are one year ahead of their counterparts, so for the skeletal maturity findings are concerned

CONCLUSION: This study concludes that for females, if appropriate radiographs [X- ray pelvis and X- ray chest] showing fusion of iliac crest and appearance of epiphysis at medial end of clavicle the age is 18 years. In male population when radiograph of proximal end of humerus bone gives impression of union, it is concluded that the person has attained the age of 18 years

Retrieval of gallbladder through epigastric port as compared to umbilical port after laparoscopic cholecystectomy

This comparative prospective study was conducted at the Ghulam Muhammad Mahar Medical College Hospital and Red Crescent General Hospital, Sukkur, Pakistan, for a period of two years from July 2012 to June 2014. The study included 1800 patients who underwent laparoscopic cholecystectomy for symptomatic cholethiasis. These patients were divided in to two groups. Group I included 900 patients, who underwent conventional laparoscopic cholecystectomy with the four port technique. In these patients, the gall-bladder was retrieved through umbilical port by a sterile surgical hand glove [size 6[1/2] or 7 inches] endobag. The fascial defect of 10 mm umbilical port was closed by vicryl "0" with J-shaped needle, while three 5 mm ports closed by applying steri strips. Group-II also included 900 patients. In these patients laparoscopic cholecystectomy was done by using three ports, 10 mm epigastric working port, 5 mm umbilical port for 5 mm telescope and lateral 5 mm port for assistant. The gall-bladder was retrieved through epigastric port without endobag. The results of both these techniques were collected and analyzed on SPSS version 14. The mean age of patients was 45 years. The male to female ratio was 1:3. In group-I, after laparoscopic cholecystectomy, gall-bladder was retrieved safely through 10 mm umbilical port in surgical glove endobag. In acutely inflamed cases, the gall-bladder was opened at the umbilical port site inside the endobag and decompressed before retrieval. In this group, wound infection of umbilical port occurred in 5.11% patients, port-site hernia in 3.66%, port-site bleeding in 1.33% while difficulty in retrieval of gall-bladder in acutely inflamed cases in 1.88% patients. In group-II, wound infection in epigastric port was found in 1.55% patients, port-site hernia in 0.11%, port-site bleeding in 4%, difficulty in retrieval of gall-bladder in 5.33% while leakage /perforation of gall-bladder in 4.11% patients. The serious complications like wound infection and port-site hernia are more frequently found in group-I patients as compared to group-II

complex - regional pain syndrome after fractures of distal radius

Objectives: The present study aims to determine frequency of Complex regional pain syndrome [CRPS] after distal radius fractures on the basis of clinical examination findings and classify into stages and to find out association of CPRS with age, genders, and risk factors. Study Design: Prospective cross sectional study Place and Duration of Study: This research work was conducted at the Department of Orthopaedics, Creek General Hospital Korangi Karachi, Pakistan from January 2013 to April 2014. Materials and Methods: This is a prospective cross sectional study of 150 cases. Follow up of patients is undertaken in out- patient department for a minimum 4 months period following injury. The percentage of patients with CRPS was identified according to IASP Diagnostic Criteria based on history and physical eamination.'.'. Patients were studied prospectively to ascertain the incidence, natural history and the degree of morbidity induced by CRPS. Results: Mean* SD age was 45.6f 14.2 years [Range = 18 - 75 years]. There were 88 [58.7%] males and 62 [41.3%] females with Male: Female = 1: 0.7. CPRS was found in 20 [13.3%] cases. Out of 20 CRPS patients 12 [60%] were female, out of 20 CRPS patients 12 [60%] had age 40 - 59 years and 8 [40%] had age >59 years. Out of 20 CRPS patients 14 [70%] were diagnosed in stage 1. Conclusion: The incidence of CRPS after distal radius fracture in this study is 13.3%.Proportion of CRPS was high in females and in old patients. Most of the patients of CRPS were diagnosed in stage 1. Diabetes mellitus, hypertension, stroke, carpal tunnel syndrome and myocardial infarction were the risk factors found in patients diagnosed with CRPS. CRPS is an under diagnosed entity. More work needs to be done on CRPS as many areas of research remains

Prevalence of self-medication and its practice among the medical and non-medical students

OBJECTIVE: To determine the prevalence of self-medication among the medical and nonmedical university students of Sindh [Pakistan]

METHODOLOGY: A Questionnaire-based cross-sectional study was conducted from Aug-Sept 2013. A convenient sampling of 400 [50% medical and 50% non-medical] students was done among universities of Sindh [Pakistan].Undergraduate students of age group [18-23] were included whereas postgraduate students, house officers were excluded. Data was analyzed using SPSS [Statistical Package for the social sciences] version 16

RESULTS: Frequency of self-medication was found to be 80%. 81% of non-medical and 81% of male students were prone to self-medication. 45% of males and 47% of medical students are aware of the contra indications when compared to females [37%] and non-medical students [33%]. 2. 75% of males and 88% of medical students know about the uses of the medicine compared to females [67%] and non-medical students [54%]. 39% males and 52% medical students have knowledge of the complications than to the females [38%] and non-medical students [25%]. The commonest health problems for which students seek self-medication are headache [40%], fever [19.5%], flu [5.2%]

CONCLUSION: Self-medication is significantly high in the educated youth. Male and nonmedical students are prone to self-medication. Self-medication among males is found to be practiced more among the Muslim States

Academic satisfaction and role of computer for medical students in public sector medical university in sindh

INTRODUCTION: It is a major challenge for universities students' academic satisfaction and it has been identified that competitive advantage, student retention, attraction for new students and positive personal communication are directly related with the student satisfaction

OBJECTIVES: To assess academic satisfaction among medical students and to analyze the use of computer time by the students in academic satisfaction

MATERIAL AND METHODS: Study design: This cross- sectional study was done in first medical University of Pakistan Liaquat University of Medical and Health Sciences [LUMHS] Jamshoro, established in year 2001

Sampling Technique: Simple Random Sampling

Sample Size: The sample size was 162 students of all semesters of MBBS

Statistical analysis: Data was computed and analyzed by SPSS version 16. Frequency and percentage were used

RESULTS: Results show that out of total 162 medical students, male were 53 [32.71%] and 109 [67.29%] were female students. Total 142 [87.65 %] students were academically satisfied and 20 [12.35 %] were unsatisfied

CONCLUSION: Our study concludes that academic satisfaction is high among students and use of computer is positively related with high satisfaction

Efficacy of nepafenac 0.1% in maintaining mydriasis during phacoemulsification surgery

OBJECTIVE: To determine the efficacy of Nepafenac 0.1% eye drops in maintaining mydriasis during phacoemulsification cataract surgery

METHODS: Patients of 40 - 65 years of age undergoing phacoemulsificaton cataract surgery were randomly divided into two groups. One group received Nepafenac 0.1% eye drops and the other group received placebo [Tears Naturale II eye drops]. Pre - operatively; all patients received tropicamide 1% eye drops and phenylephrine 2.5% eye drops

The surgery in all the cases was done by the same ophthalmologist; with intra - operative epinephrine in the irrigating solution. The pupil size was measured with caliper at three steps; immediately before the surgical incision [baseline], at the end of phacoemulsification, and at the end of surgery

RESULTS: 60 eyes of 60 patients were included in the study. 30 eyes were in the Nepafenac 0.1% group and another 30 in the placebo group. The mean age of our patients was 54.18 +/- 7.49 years. The mean diameter of pupil at end of surgery was 7.65 +/- 0.71 mm in Nepafenac group V/s 6.67 +/- 0.97 mm in the placebo group [P- Value < 0.001]

In the Nepafenac group; the pupil size at the end of surgery decreased by a mean of 0.55 +/- 0.51 mm [range 0.00 - 1.50 mm]. Meanwhile; in placebo group the pupil size decreased by a mean of 1.05 +/- 0.87 mm [range 0.00 - 3.5 mm]. This difference was statistically significant [P = 0.009]

CONCLUSION: The pre - operative use of Nepafenac 0.1% eye drops was effective in maintaining mydriasis during phacoemulsification cataract surgery

Integration of preventive and curative health services for flood survivors by lumhs - a successful health care model for preparedness of future floods in Pakistan [A Community Based Research Survey]

OBJECTIVES: The objectives of this study are to collect demographic data of survivors for assessing the related common disease, to identify steps in implementation of essential preventive and curative care for flood survivors and to develop health care model for super flood disaster preparedness in Indus valley areas

STUDY DESIGN: It was a cross sectional descriptive Epidemiological Study /survey. Date was collected through structured and designed proforma. This proforma was tested. 4[tth] year MBBS students were filling proforma and survey work supervised by Faculty of department of Community Medicine and public health sciences and LUMHS clinical faculty members. The study was conducted on survivors and internally displaced people [IDPs /survivors] during super Indus river flood in August and September 2010 to observe and evaluate the role of medical university for the preventive and curative health services for flood victims to reduce the morbidity, mortality and miseries in disaster times

PLACE OF STUDY: The flood victim camps on both sides of Indus river bank from Sehwan to Kotri covering districts Dadu, Jamshoro, Matiari and Hyderabad and also tent cities at Sehwan, Sabzi Mandi Hyderabad and Ghulshan-e-Shahbaz Jamshoro

DURATION OF STUDY: 8[th] August 2010 to 31st December 2010

RESULTS: Total 161700 Flood Survivors were provided health care by LUMHS medical teams, Faculty consultant, Doctors, Students and Paramedics through organizing free medical camps in tent cities and mobile camps. There were 113190 [70%] Female survivors and 48510 [30%] were Males survivors. The health teams provided curative care to 59500 [36.79%] and preventive care to 102200 [63.21] super flood survivors. Ten thousands were sheltered at the land of LUMHS campus and tent city. The common diseases were Diarrhea [21%], ARI [16%], Malaria [07%], Skin Diseases [17%], Eye Infections [08%], Ear Infections [04%], Malnutrition [15%], Injuries [02%], Sleep Disorders [0,5%], Heat Stroke [0.3%], Dog Bite [0.1%] and Unspecified [0.1%]

CONCLUSION: Flood survivors need preventive and curative care. The medical university can directly provide emergency health care and can contribute human resources comprising Faculty, Doctors, Students and Paramedics. 161700 were beneficiaries of LUMHS developed health care model which is one of the indigenous and successful model for future flood disaster preparedness in Pakistan. The WHO acknowledged LUMHS services for flood victims. Professor Noshad Ahmed Shaikh, Vice Chancellor, Liaquat University of Medical and Health Sciences, Jamshoro supervised and visited camps regularly

severely anemic young woman with multiple leiomyomas

Uterine leiomyoma, or fibroids, are most common benign tumors of the uterine smooth muscle and extracellular matrix in women of reproductive age. They can range in size from very tiny [a quarter of an inch] to larger than a cantaloupe. Sometimes they can cause uterus to grow to the size of four to five months of pregnancy. Most of the fibroids are asymptomatic using sensitive imaging techniques1, however, woman with pain and heavy menstrual bleeding depending on their location have limited treatment options. The fibroids can grow under the influence of the hormone estrogen and are most often seen after the menarche, and tend to shrink after the menopause. Typically the patient is nulliparous or of low parity. Common complications of uterine fibroids include menorrhagia with symptoms of dysmenorrhoea, pressure symptoms, abdominal distension, and infertility

Radiological indicators for determination of age of consent and criminal responsibility

Objectives: to establish radiological markers, by ossification form of appearances and fusion for determination of Medico legal important ages for consent and criminal responsibility, for our population

Study design: perspective observational study

Setting: Department of Radiology and Imaging, Liaquat University Hospital Jamshoro / Hyderabad Sindh

Study period: June 2006 to December 2008

Method: Total 1381 Subjects comprising of 617 female and 764 male, free from any musculoskeletal, nutritional and endocrinal disorder and confirmed dates of births were selected, representing the population of Hyderabad city and adjoining areas. The Subjects were divided into 9 groups on the basis of their age and purpose of study. Radiographs of wrist, elbow, shoulder and hip were taken in accordance to the age group and anticipated findings and radiological changes were observed and recorded

Results: Radiograph of wrist showing ossification of trapezoid at the age of 7 years and pisiform at 12 years in both sexes in 100% of cases proved to be a good indicator of the required age groups. fusion of Epiphysis distal Radius and ulna, proximal Hummers and iliuc crest can be relied upon as age indicator in Females and Males from 16 to 18 years

Conclusion: The outcome of this study provides more accuracy with a margin of error of +/-2 months and can be utilized for our population with confidence in medico legal disputes

Hemodynamic effects of repeated bouts of mental stress

Objectives: to determine whether repeated stints of mental stress had similar cardiovascular effects [CV] and also to establish that mental arithmetic tasks affect CV parameters and have reproducibility of the effects

Design: cross Sectional, observation study

Setting: medical School, University of Nottingham, UK

Methods: ten healthy, white European males participated in this study. Employing a Finometer, beat-to-beat CV parameters were recorded for 30 min baseline. Volunteers undertook mental arithmetic task [MAT] thrice, with different sets of questions each time, displayed as Power Point slides. Fifteen min interval lapsed between the tests; post MAT-3 recordings then continued for 10 min before the experiment ended

Results: no significant difference between the three baseline values was noted. MAT resulted in significant elevation of SBP, 20 mmHg [15%], DBP, 14 mmHg [18%], MAP, 18 mmHg [19%], HR 26 beats/min, i.e., 42% and CI by 4.35l [50%] from the baseline [P < 0.001] whereas TPR decreased by 0.213 units [-21%; P < 0.001]. CV variables returned to baseline as the task ended. Effects of MAT-1 -2 and -3 on the CV variables were similar [P > 0.05]

Conclusion: repeated exposure to mental stress results in identical CV reactivity response, effects are attributable to adrenaline gush and that quick adaptation to stressor does not occur; recovery may take place with CV parameters returning to the baseline as soon as stress was over

Haemodynamic effects of fructose and sucralose in healthy, white caucasian males

Objective: To determine the acute haemodynamic changes produced by the ingestion of fructose or sucralose solutions in water

Setting: Medical School, University of Nottingham, Queen's Medical Centre, Nottingham, UK

Material and Methods: Ten, healthy, non-smoking, white Caucasian males, aged between 18-40 years ingested solutions containing fructose (0.75 g/kg body weight) or sucralose dissolved in 500 ml of water, on separate days. Volunteers rested semi-recumbent on a bed in a thermo-regulated environment and a 'Finometer' was used to record beat-to-beat blood pressure (BP), cardiac output (CO), heart rate (HR), total peripheral resistance (TPR) and stroke volume (SV) for 30 min baseline, 5 min during ingestion and for 60 min post ingestion

Results: There was a significant rise in diastolic BP (DBP) and mean arterial pressure (MAP) from the baseline with fructose and sucralose drinks and in systolic BP (SBP) with the fructose drink (P < 0.05). Trends for a rise in systolic BP (sucralose), TPR, HR and CO (both fructose and sucralose) were observed. However, there was no statistically significant difference between the drinks containing either fructose or sucralose in the responses of the above variables

Conclusion: Ingestion of fructose and sucralose increases BP. Sucralose produce effects that are similar but smaller than fructose

Veress needle versus direct trocar insertion techniques for inducing pneumoperitoneum in laparoscopic procedures

To compare the safety and complications of veress needle [VN] versus direct trocar insertion [DTI] techniques in laparoscopic procedures. Comparative study. The study was conducted at three different hospitals in Karachi from October 2005 to May 2011. A total of 1050 consecutive laparoscopic surgeries were done during the study period. Female to male ratio was 2.5:1. In 73% of the cases direct trocar placement was done while in 27% pneumoperitoneum was achieved with Veress needle. Variables noted included technique, complications, and duration of surgery. Data was analyzed statistically using SPSS version 16. Female to male ratio was 2.5:1.Complications were more in direct trocar insertion method. Overall total complications were 3.4%. One percent in group I [VN technique] and 4% in group II [DTI technique] had complications [p=0.017]. No visceral injuries were noted in either group, but pre-peritoneal insufflations found in 2 patients [0.25%] in group II. Late complications were more in group II. This include wound infection [1.5%], late wound bleeding [0.9%], port site hernia formation [0.9%] and chronic sinus formation [0.38%].All these were statistically insignificant except wound infection [p 0.036]. Veress needle method is as safe as direct trocar insertion method in expert hands

Complications in metal-ceramic fixed dental prostheses among patients reporting to a teaching sental hospital

Aims and Objectives: This study aimed to report the distribution of biological and technical complications and their levels in patients' fixed dental prosthesis [FDPs] reported to Prosthodontics Department, Khyber College of Dentistry Peshawar [Pakistan]

Methods: During February 2007 to Jan 2008, a descriptive study was conducted. Data relating to 124 patients having complications with their levels in metal-ceramic FDPs were collected using a structured proforma, by the methods of patient's interview, clinical and radiographic examination. Data related to age, gender, types and levels of biological and technical complications, the FDP fitting place, FDP location in the dental arch as well as of the post-fitting duration were also recorded

Results: Subjects had mean age of 37+11 years. Male to female ratio was 1.3:1. Distribution of FDPs was; hospital-fitted [56.4%], private-practice-fitted [32.2%] and quacks-fitted [11.2%]. Distribution of 210 noted complication events with reference to fitting place was; hospital-fitted [60%], private-practice-fitted [30%] and quack-fitted [10%]. Some 29% complication events were in FDPs not older than a year, 46% in those not older than 5 years and 25% in those older than 5 years. Complication were; de-cementation [24.8%], caries [20.5%], peri-apical problems [18.1%], periodontal problems [11.1%], prosthesis fractures [9.1%], abutment fracture [7.1%], occlusal problems [6%] and esthetic-problems [3.3%]. Not-withstanding the varying levels of individual complication events, level-1 complications were 43%, level-2 were 44% and level-3 were 13%

Conclusion: Irrespective of the types and levels, some 75% complications occurred in FDPs not older than 5 years

Frequency of hepatic hydrothorax in patients with liver cirrhosis: a tertiary care hospital experience

Objective: present study was designed to find out the frequency of hepatic hydrothorax among the patients with liver cirrhosis in a tertiary care hospital

Methods: this prospective observational study was carried out at the Hepatology Section of Department of Medicine, Isra University Hospital, Hyderabad, from December 2005 to May 2006. All the consecutive patients suffering from cirrhosis of liver were included and studied for the presence of hepatic hydrothorax. Results were summed up and test parameters were compared statistically

Results: the total number of patients was 128, and the mean age of these patients was 48.6 years. Frequency of hepatic hydrothorax in all patients with cirrhosis was 5.5% [7/128]. It was seen that highest frequency of hepatic hydrothorax was found in Hepatitis C cirrhotic patients [4/7]. The second most common occurrence was found in hepatitis B cirrhotic patients [2/7]. In other types [non "B", non "C"] it was 1/7

Conclusion: the frequency of hepatic hydrothorax at our center is similar as reported in the world literature

Frequency of hepatitis B and hepatitis C in patients with hepatocellular carcinoma at Hyderabad

Objective: to determine the frequency of hepatitis B and Hepatitis C in patients with hepatocellular carcinoma in two university hospitals of Hyderabad

Study design: descriptive observational study

Place and duration: this study was conducted at Liaquat University Hospital Hyderabad and Isra University Hospital Hyderabad from November 2005 to October 2008

Material and methods: clinically diagnosed hepatocellular carcinoma [HCC] cases were confirmed pathologically. Demographic and clinical information was recorded on a predesigned proforma. Serological assessment for hepatitis B, hepatitis C and delta virus was carried out through ELISA

Results: a total of 200 cases of hepatocellular carcinoma were included in this study. Hepatitis C antibody was present in 145 [72.5%] cases. HBsAg was present in 42 [21.0%] cases. Thirteen [6.5%] cases were infected by multiple viruses. Twenty-one [10.5%] cases were alcoholic as well as infected by hepatitis C and 1 case [0.5%] was only alcoholic. Twelve cases [6.0%] were neither alcoholic nor having any viral etiology

Conclusion: HCV alone was most frequent presentation in cases of HCC followed by HBV, emphasizing their etiological association