Tuberculosis; patients knowledge, attitude and perceptions

Tuberculosis is one of the major public health problems in Pakistan. Pakistan ranks fifth amongst TB high-burden countries worldwide and accounts for 61% of the TB burden in the WHO Eastern Mediterranean Region. To describe knowledge, attitudes, and perceptions among the patients of pulmonary tuberculosis about their disease attending outpatient department at independent university hospital Faisalabad. A descriptive cross-sectional study. August to September 2014. Out patients department at Independent University Hospital Faisalabad. A total of 197 patients from OPD. Systematic random sampling technique. After an informed consent a pretested questionnaire were used to collect the information from the patient. SPSS-17were used to calculate the frequencies and percentages. Out of 197 respondents were 55.3% [109] male, 44.7% [88] female and 63% [125] were earning below 10000 rupees per month. As for as knowledge is concerned 50% of the patients viewed that TB is transmitted through contact with the patients having tuberculosis, 83%labelled cough of long duration as commonest sign, 60% viewed that it can be prevented by avoiding contact with patients, 57% labeled healthcare staff as their source of information, 65.9% perceived TB as an infectious disease, 55% stress as cause of disease, 85% as not curable disease. Poor knowledge and false perceptions are the main constrain in the control of TB in Pakistan

Knowledge and understanding of medical students about radiotherapy and palliative care

To assess the knowledge of undergraduate medical students about radiotherapy, cancer and palliative care in cancer. A descriptive study to assess the knowledge of radiotherapy, cancer and palliative care is conducted among undergraduate medical students of Dow Medical College. 300 students from each batch of fourth and final year were assessed for knowledge of radiotherapy, palliative care, cancer knowledge, cancer prevention, students' visits to radiotherapy units, source of cancer information, teaching programs of radiotherapy in medical college, choice of career and participation in palliative care course during their undergraduate years. 246 questionnaires were returned. 41% of students correctly answered to different questions related to the knowledge about radiotherapy. Data regarding cancer treatment knowledge among students showed an average of 32%. The general knowledge regarding cancer among the students was present in approximately two thirds [60%] of participants. The knowledge regarding cancer prevention prevailed around 36.04%. There is a need to change the perception of palliative care and radiation therapy among medical students. Teaching of radiotherapy should begin early in the undergraduate curriculum of MBBS, and it should be mandatory for all the students. Oncology rotations should be constructed where the principles of radiotherapy and palliative care can be conveyed

Comparison between role of honey dressing and oxoferin [tetrachlorodecaoxide] dressing in the management of infected wounds in diabetic amputated limbs

Introduction: Diabetic ulcer is a very common entity encountered in the general surgical practice. The problem needs keen interest and meticulous wound care for its management to prevent serious complications of these infected and gangrenous ulcers

Objective: The objective of the study was to compare the efficacy of honey dressing and oxoferin [tetrachlorodecaoxide] dressing in the management of infected wounds in diabetic amputated limbs

Study design: Randomized clinical trial

Setting: Surgical Unit-IV of Districted head quarter hospital Faisalabad

Subjects and Methods: The total sample size comprises of 98 patients were divided into two groups A and B. Group A was treated with honey dressing while group B was treated With oxoferin [tetrachlorodecaoxide] dressing. Area of the wounds to be dressed was measured in two largest dimensions and noted in cm. Sterile gauzes soaked in commercially available tube packed honey and oxoferin [tetrachlorodecaoxide] solution were applied over the wounds. Outcome of the both methods were assessed by measuring of the size of the wound at presentation and then after one week

Results: Significant decrease in wound size in oxoferin group was in 24 patients [49%] and in honey group was in 11 patients [22.4%]

Conclusion: Although the clinical experience detailed in this study showed better results to oxoferin as compare to honey dressing, more quality randomised controlled trials are needed to provide evidence to encourage the use of honey in wound care

Breast cancer; frequency of risk factors

To assess the risk factors for breast cancer in patients attending oncology OPD of civil hospital Karachi, Pakistan. Introduction: Breast cancer is the single largest cause of death among women1,2. The probability of American woman developing breast cancer in their life is 7 in 11. Studies from subcontinent show that the incidence of breast cancer is increasing, with an estimated 80,000 new cases diagnosed annually. Breast cancer is the second most common type of cancer after lung cancer in Pakistan and ranked first in women. Only 10% women are diagnosed, out of them, 75% women do not get treatment and die within 5 years6. Data from Pakistan about the risk factors or association is not only scanty but also does not comment on the use of fatty diet in breast cancer patients. A cross-sectional descriptive study conducted at Oncology OPD of civil hospital Karachi [CHK] from October 2009 -April 2011. One Hundred and Fifty consecutive patients having histopathalogical diagnosis of breast cancer were assessed for different risk factors that included marital status, parity, age, menopausal status, family history of breast cancer, prolong use of oral contraceptives, breast feeding, , early menarche, trauma to the breast and fatty diet. Mean age of patients was 48 years. Three fourth [73%] of these female were above the age of 40 years. Consumption of fatty diet was found in 62.67% while positive family history of breast cancer was present in 34% of the cases. Early menarche and being nulliparous were not as strong risk factors as in previous studies. Our study has highlighted the need of further exploration in this area that would not only help this population but also enhance our understanding of different risk factors. This will have important implications for the overall management of breast cancer

Neurally adjusted ventilatory assist [NAVA] mode as an adjunct diagnostic tool in congenital central hypoventilation syndrome

A full term female newborn was admitted to the neonatal intensive care unit [NICU] for continuous observation of apnea. Infant was noted to have apnea while asleep requiring intubation and mechanical ventilation. A video EEG was performed which demonstrated normal awake background without any seizure activity. Neurally adjusted ventilatory assist [NAVA] demonstrated the absence of electrical activity of the diaphragm [Edi] when the patient was in quiet phase of sleep. This finding on NAVA monitor raised the suspicion of central hypoventilation syndrome [CCHS] which was confirmed by genetic identification of the PHOX2B mutation

Factors affecting BMI assessment of the effect of sociodemographic factors on BMI in the population of Ghulam Mohammad Abad Faisalabad

To examine the effect of different sociodemographic factors on the BMI. Descriptive Cross Sectional Study. People of Ghulam Mohammadabad and Marzi Pura attending OPD at Independent University Hospital Ghulam Mohammadabad and Marzi Pura Faisalabad. One Month of duration extending from July to August 2012. 493 respondents were selected by convenient sampling. A semi structured questionnaire was used to collect the information from the sample. First of all, an informed consent was obtained from the respondents under study and secrecy of the information was ensured. By data analysis through SPSS Version 17, frequency tables were prepared. The result of this study shows that BMI is less than 18.5 in 25.4% of the males as compared to 11.5% in females. 22.9% married persons were having BMI above 30 as compared to 6.6 percent unmarried. This study also shows 21.1% of the smokers were having BMI above 30 as compared to 18.3% in non smokers. Similarly 18.2% of the respondents sleeping less than 10 hours per day were having BMI above 30 as compare to 15.4% sleeping more than 10 hours per day. Result also shows 25.8% diabetics having 18.5 to 24 BMI while 21.5% in non diabetics. There was family history of obesity in 22.4% only. Males are more underweight as compared to females and that females are always on higher side of BMI. Married persons were more obese as compared to unmarried. Per month income, background history of diabetes mellitus and family history of obesity found to have a profound effect on BMI

Congenital epulis

Epulis is a rare tumour, with female preponderance that is only seen in the newborns. It arises from the mucosa of the gingiva and protrudes out of the infant's mouth. It can potentially obstruct the airways and may require an EXIT [ex-utero intrapartum treatment] procedure which involves establishing an airway before the feto-maternal circulation is interrupted. We present a female newborn with such a mass, which was diagnosed antenatally. A multidisciplinary team including the neonatologist, anaesthesiologist and ENT specialist should be present in the delivery room to establish the airways, which may require an EXIT procedure. Recommended treatment is early surgical resection. Recurrences of the tumour and damage to future dentition have not been reported, suggesting that radical excision is not warranted

Neurally adjusted ventilatory assist mode used in congenital diaphragmatic hernia

A term baby with congenital diaphragmatic hernia [CDH] underwent surgical repair on the second day of life. Postoperatively; the oxygenation index increased to 85 despite high pressure ventilation with HFOV [high frequency oscillator ventilation] and inhaled nitric oxide therapy. Oxygenation index above 70 carries a mortality rate of 94% and merits starting extracorporeal membrane oxygenation [not available in the UAE]. A trial of neurally adjusted ventilatory assist [NAVA] on the 10th postoperative day was followed by a reduction of oxygenation index to 15 and marked improvement of the clinical parameters. The EAdi [electrical activity of diaphragm] signal was relatively weak [ +/- 5 micro volt] requiring augmentation witha high NAVA level [3 - 3.5]. The patient was successfully extubated after 3 weeks

Bone marrow examination in ITP in children: mandatory?

To determine the need of bone marrow examination in children with idiopathic thrombocytopenic purpura [ITP] at initial presentation. Descriptive study. Pediatric Units of Children Hospital, Islamabad, from January 1 999 to December 2003. All children, clinically suspected to have ITP, who underwent bone marrow examination, were included After reviewing the file records of these patients for history, examination and investigations, a predesigned proforma was filled and data was analyzed, using SPSS version 10 for statistical analysis. The results were reported in the form of frequencies, percentages and mean. A majority of the children were between 48 to 96 months, with a mean age of 54.43 months. Male to female ratio was 1.45:1. Mean platelet count was 33861/mm3. None of the bone marrow results showed the presence of abnormal cells consistent with hematological malignancy. ITP was the final diagnosis in 52 patients. One patient was diagnosed to have megakaryocytic hypoplasia. Bone marrow aspiration in one patient was hypoplastic, and subsequently, he was diagnosed to have aplastic anemia on trephine biopsy. Bone marrow aspiration should not be a part of routine work-up for diagnosing ITP in children and should be reserved for those children having atypical clinical and laboratory features

Association between iron deficiency anemia and Febrile Seizures

To find the association between iron deficiency anemia and febrile convulsions among children presenting at the Aga Khan University Hospital, Karachi. Case control study. Paediatric Department of the Aga Khan University Hospital, Karachi, from January 2001 to December 2001. A total of 60 patients fulfilled the study criteria of febrile seizure or any febrile illness. These were divided into two groups with children having febrile seizures comprised the cases while those having only febrile illness with no seizures comprised the controls. Both groups had equal number of children matched for age and gender. Workup for seizures and iron deficiency anemia was done and data was analyzed using SPSS version 10. The mean age for cases [group A] was 22.97 +/- 9.52 months while that for controls [group B] was 22.77 +/- 11.33. There was also no significant difference in the gender distribution in the two groups. Iron deficiency anemia was significantly more frequent among the cases as compared to the controls as evident from parameters studied i.e. hemoglobin <10g/dl [p-value= <0.000], hematocrit <30% [p= <0.01], MCV <70fL [p=<0.002], MCH<24pg [p= <0.001] and serum ferritin <10ng/ml [p= <0.000]. Plasma ferritin level was significantly lower in cases as compared to controls suggesting that iron deficient children are more prone to febrile seizures. A follow-up study of patients found to be iron-deficient at the time of a first febrile seizure to determine the incidence of subsequent febrile seizures after treatment for iron deficiency would be of great interest