HIV infection; prevalence among intravenous drug users

Human immune deficiency virus [HIV] infection was a major health problem all over the world. The infection had become pandemic and no country was immune. The main burden of disease was shared by developing countries and their crippled economies were unable to deal with it. As a result the number of HIV patients were increasing day by day. Treatment was expensive and preventive measures were not effective. The intravenous drug users [IDUs] were major contributors in its spread. To assess the prevalence of HIV infection by determining the frequency of HIV infection in intravenous drug users.Cross-sectional study. Rehabilitation center for IDU,s in District Headquarter Hospital Faisalabad [DHQ], a Tertiary Care Hospital, Affiliated with Punjab Medical College during Jan.2013 to Dec.2013. Subjects and All I. V. drug users attending the rehabilitation center of D.H.Q. hospital were included in the study. All were subjected to be screened for HIV/AIDS infection. Total 352 patients attended the center. Each patient was given a code number to hide the identity and results of tests were kept secret. The blood samples were collected and labeled with respected code on it. Total 352 intravenous drug users were enrolled at rehabilitation center and 96 were tested positive for HIV infection. Another 62 belonged to urban area and 34 belonged to rural area. About 80 were living with their families and 16 were living out of their families. The 78% were not having sufficient earnings for their living. Intravenous drug users were threat to public health in transmitting HIV infection by sharing needles

Substance abuse; among prisoners and its consequences

To study the prevalence of substance abuse among prisoners and its effects on other inmates. A cross sectional study. Central jail Faisal Abad Pakistan during Jan. 2012 to Feb 2012. All the convicted and condemned prisoners were included in the study and those exclusively charged for drugs abuse crimes were excluded. A snow ball convenient sampling technique was adopted. Sample size was not predetermined. The study population was [1080] male and above the age of 18 years. About one hundred and eighty four [184] prisoners were found using different drugs. Among them seventy six 76 [41.3%] started using drugs on entering the prison and one hundred and eight 108 [58.7%] were using drugs before coming to prison. The 91[49.5%] belonged to rural area and 93 [50.5%] belonged to urban areas. The most commonly used drug was heroin 181[96.7%] and 3[.6%] used different drugs like injections or pills. Substance abuse among prisoners was increasing day by day leading to increased crimes, health issues, and significant economic constrains in every country especially among poor nations. Strong political will and public motivation was the need of time to deal with the issue

Comparison of morbidity in rubber band ligation and milligan morgan hemorrhoidectomy

Background: Hemorrhoidectomy treatment has multiple options, depending on grade of disease

Objective: This study was conducted to compare the postoperative morbidity of rubber band ligation [RBL] and milligan morgan haemorrhoidectomy in terms of frequency of pain and bleeding in patients with third degree hemorrhoids

Material and Methods: This study was conducted in Department of Surgery, District Headquarter Hospital Faisalabad, affiliated with Punjab Medical College from 25[th] January, 2012 to 24[th] January, 2014. This study included 140 [70 in each group] patients of grade 3 hemorrhoids. Patients were randomly allocated into either the rubber band ligation [RBL] group or milligan morgan haemorrhoidectomy groups by using computer generated random number tables. Both groups were observed for the impact of these treatment modalities on post operative pain and bleeding

Results: In group A, 49 patients [70%] and in group B, 47 patients [67.2%] were male. Regarding postoperative pain, 2 patients [2.9%] of group A and 22 patients [31.4%] developed mild postoperative pain [p<0.001], 1 patient [1.4%] of group A and 31 patients [44.3%] of group B faced moderate postoperative pain [p<0.001], 1 patient [1.4%] of group A and 11 patients [15.7%] has severe postoperative pain [p=0.002]. In group A, 2 patients [2.9%] and in group B, 10 patients [14.3%] has mild postoperative bleeding, 1 patient [1.4%] in group A and 8 patients [11.4%] in group B developed severe postoperative bleeding

Conclusion: RBL is a reliable and safe procedure with minimum complications and morbidity after the procedure

Impact of early tracheostomy on outcome in tetanus patients

Background: Tetanus is a disease with high mortality, and different treatment modalities are being tried

Objective: The objective of this study was to compare the impact of early tracheostomy on outcome in tetanus

Patients and Methods: This randomized clinical trial, was carried out in Surgical Unit-5, DHQ Hospital, Faisalabad, Pakistan from 1[st] January, 2012 to 31[st] December, 2013. Sixty patients of tetanus [grade-2] of any age and sex, diagnosed clinically were taken and divided into two groups, 30 patients in each. One group was given only medical treatment and second group was given medical and surgical treatment and both groups were observed for the impact of these treatment modalities on outcome. The data was entered and analyzed in SPSS version 17

Results: Out of 30 patients who underwent medical treatment, 10 [33.3%] were cured and 20 [66.7%] were expired. Among patients who underwent both medical and surgical treatment, 18[60%] were cured and 12 [40%] expired. 21[70%] developed tracheostomy complications and 9 [30%] did not develop any complication. [P-value < 0.05]

Conclusion: Tracheostomy in early stages of tetanus has mortality benefit and it is associated with less morbidity and mortality

Tetanus; still cannot be prevented, a three year retrospective study in DHQ hospital, Faisalabad

Tetanus still remains a major public health problem in Pakistan like in most other developing countries, with a high morbidity and mortality. To study the demographic profile the clinical profile, the outcome of the tetanus patients and effectiveness of tetanus immunization coverage in district Faisalabad. Retrospective record based study. Surgical unit-5 DHQ Hospital, Faisalabad from January 2010 to December 2012. All data of 198 patients of tetanus of any age and sex, diagnosed clinically was collected, compiled and analyzed from the Medical Records Department of the Hospital. Out of 198 patients of tetanus,138[69.7%] were males and 60[30.3%] were females. Their ages ranged from 1 to 85 years with a mean and a standard deviation respectively of 29.36 and 17.48 years.162 [81.8%] were from rural and36[18.2%] were from urban areas. 47[23.7%] patients were having prior immunization and151[76.3%] were not immunized. The most common presenting symptoms were trismus [47.5%], body stiffness [24.2%],fits[19.2%] and respiratory distress[9.1%]. 23[11.6%] patients were having mild disease,71[35.9%] patients were having moderate disease,71[35.9%] patients were having severe disease and 33[16.7%] were having very severe disease. Overall mortality rate was 41.4%. Respiratory failure was the most common cause of death and there was statistically significant association between mortality and increasing grades of disease. By making expanded programme of immunization [EPI] more effective and removing flaws from out-dated vaccination through incomplete vaccination. By improving awareness in public and complete vaccination through EPI program, we can reduce the incidence of tetanus

HIV Infection, HIV/HCV and HIV/HBV co-infections among Jail Inmates of Lahore

Human immunodeficiency virus [HIV] infection constitutes an important prison health care concern but data on HIV epidemiology among jail inmates of developing world including Pakistan is limited. The present study was carried out to find out the prevalence of HIV infection among inmates of two jails of Lahore, Pakistan. Cross sectional prevalence survey of a total of 4915 jail inmates [4498 male and 417 females] was conducted during a seven months period, from May 2009 to November 2009 in the inmates of "District and Central Jails of Lahore". They were divided into four groups according to age. A blood sample was collected from each survey participant. All collected blood samples were screened for HIV antibodies, HBsAg and anti-HCV with rapid testing immunochromatographic [ICT] kits. All positive test results were confirmed by using the ELISA technique. The overall HIV prevalence rate was 2.01% and 77.78% of them had co-infections. HIV/HCV co-infection was detected in 73.74% of HIV positive inmates. Among women prisoners, one Pakistani and four Africans were found HIV positive. HIV infection and HBV/HCV co-infection was more prevalent in the age group 16-30 years. The prevalence rate of HIV infection and its HBV/HCV co-infection in jail inmates is much higher than the general population and the prevalence rate reported earlier from other jails in Pakistan. Health information on jail populations is important as this is a vulnerable group, with frequent movement in and out of the general community. Urgent prevention efforts are needed as HIV prevalence is already 2%

Inborn errors of amino acid and carbohydrate metabolism

This study was conducted with two objects in mind. Firstly, to screen children who were under two years of age for detection of inborn errors of Amino Acid and Carbohydrate metabolism. Secondly, a group of cases of proved mental deficiency were screened to find out whether the inborn errors of Amino Acid and Carbohydrate metabolism are a significant contributory factor to the mental deficiency in Pakistan. Department of Pathology, PGMI/ KEMC/ Mayo Hospital Lahore. In this study, two groups of subjects were investigated systematically to detect inborn errors of amino acid and carbohydrate metabolism with particular reference to Alcaptonuria, Phenylketonuria, Galactosemia, FruSosuria and pentosuria. In group I - 2000 children, under 2 years of age, mostly newborns, were randomly selected for this study from Pediatrics department of various hospitals of Lahore. Group II - Includes 30 cases of mental deficiency of various ages referred by the psychiatrists or pediatricians for verifying whether any inborn error of Amino Acid or Carbohydrates metabolism is present or not. Chemical screening tests along with one dimensional descending paper chromatography and thin layer chromatography [TLC] were employed to detect metabolic errors. In group I, one case of alcaptonuria was detected In group II, Three cases of a specific generalized aminoaciduria occurring in a single family were detected. This study indicates that inborn errors of metabolism also exist in Pakistan. It has also sorted out a reliable scheme of screening and detection of these disorders suited to our socio-economic.environment. The importance of early suspicion of these disorders and a timely diagnosis during preventable stage has been stressed and the need of a national screening programme highlighted