Arterial blood gas levels in high altitude Kashmiri population, India.

Background: The valley of Kashmir lies at an average height of 1730 m above the sea level with a barometric pressure of 624 mmHg. The fall in atmospheric pressure at higher altitude decreases the partial pressure of inspired oxygen and hence the driving pressure for gas exchange in the lungs. At sea level the normal range of PaCO2 is 35 mmHg to 45 mmHg and at 1500m above sea level (barometric pressure 634 mmHg), the predicted normal PaO2 in a healthy young adult is approximately 80 mmHg; this contrasts with a value close to 95 mmHg at sea level. On these grounds this study was undertaken to formulate normal ABG values for this place as it lies at a higher altitude. Methods: The study was undertaken to measure "arterial blood gases" (ABG) in ethnic Kashmiri population and consisted of a sample of one hundred healthy Kashmiri subjects of either sex after proper inclusion and exclusion by spirometrically measuring Vital Capacity and Forced expiratory volume in one second/Forced vital capacity (Fev1/FVC). A modified Allen's test was performed to check for adequate collateral circulation ruling out Ischemia. Results: The average mean PaO2 of 78.51 ± 4.40 mmHg and the average mean PaCO2 of 33.37 ± 2.38 mmHg was obtained of the volunteers of both the sexes. The average mean pH of males (7.43 ± 0.02) was significantly lower than the mean pH of females (7.45 ± 0.021). Conclusions: The present study might provide useful base line normal values of Arterial Blood Gases for the local population and will be beneficial to the clinicians.

Control of bleeding by silk ligation and diathermy coagulation during tonsillectomy: a comparison of efficacy of the two techniques in the first 24 hours after surgery

To assess and compare the relative efficacy of silk ligation and diathermy coagulation techniques in controlling bleeding during tonsillectomy in the first 24 hours. This prospective study was conducted at the Department of ENT, Khalifa Gul Nawaz Teaching Hospital, Bannu and this department related consultants' private clinics from January 1, 2012 to December 31, 2014. The study included 180 cases. All patients included were having history of recurrent, acute tonsillitis, with more than 6-7 episodes in one year, five episodes per year for two years, or three episodes per year for three years. All the surgeries were performed by dissection method. Haemostasis during the procedure was secured by either ligation with silk 1 or using diathermy. The results were analyzed using SPSS 16.0 for windows. A total of180 cases were included in the study. The ages of the patients ranged from 5 to 40 years with the mean age of 15.56 years and a std.deviation of +/- 8.24. The male to female ratio was 1.25:1. The number of hemorrhages occurring was greater in the 'diathermy coagulation' group as compared to the 'silk ligation' group. However, the observed difference was statistically insignificant [p >.05]. Primary haemorrhage occurring during tonsillectomy is a serious threat and control of bleeding during the procedure should therefore be meticulous. Both suture ligation and coagulation diathermy for control of bleeders during the procedure by dissection method are equally effective

Glucose intolerance in relation to socioeconomic status and gender in population of Srinagar city

To assess the pattern of type -2 diabetes in different socioeconomic groups in the urban and peri-urban areas of Srinagar city. A detailed questionnaire on the Socioeconomic and Clinical background of the 1040 subjects was collected. After an overnight for blood fasting blood samples were drawn for determination of plasma glucose. Diagnosis of diabetes was based on the American Diabetes Association [ADA 2004]. The overall Prevalence of the diabetes in the study population was 6.05% which included 4.03% of known diabetic and 2.02% undiagnosed subjects. There was significant difference between the prevalence of type 2 diabetes in men and women [3.6%vs 8.3% respectively, P=0.0013]. Subjects belonging to higher socioeconomic status had greater prevalence of diabetes compared to lower 17.4% vs 3.2% [P<0.001][middle class [class II and Class III] versus lower class[Class IV]respectively]. Socioeconomic factors influence the occurrence of diabetes in this study population, with prevalence being more come in the middle class

Kochia Indica Wight - an unusual foreign body of the upper airways in children

To highlight the special features of an unusual foreign body of the larynx, the seed of kochia indica wight, and discuss its management. This prospective study was conducted at the Department of ENT, Khalifa Gul Nawaz Teaching Hospital Bannu, District Headquarter Teaching Hospital, Bannu and this department related consultants' private clinics from January 1, 2009 to December 31, 2011. The study included 32 cases. All the patients underwent direct laryngoscopy for removal of foreign body. The main indication for direct laryngoscopy was a definite history of foreign body inhalation and acute onset of hoarseness in predisposed children. The results were analyzed using SPSS 16.0 for windows. A total of 32 cases were included in the study. The age range was 5-15 years. There were 14 males and 18 females. All the patients presented with hoarseness of voice and dry irritating cough. Odynophagia was seen in 56.2% cases whereas breathing difficulty was present only in 9.4% of cases. The foreign body was lodged lateral to anterior 1/3rd of the cord in 62.5% followed by lateral to mid cord in 31.2% cases. Kochia indica wight seed is an unusual but a common foreign body of the larynx in the southern districts of Karak and Bannu. The diagnosis is easy in the predisposed children. Though it does not change its position in the larynx, yet urgent removal should be undertaken as foreign body in the larynx is potentially a life threatening condition.