Atherosclerosis in relation to fat penniculus [obesity] between xiphoid and umbilicus

It has been shown that possible influence of body weight is more evident for coronary than aortic atherosclerosis; and more in men than women. Coronary heart disease due to obesity in males becomes significant when body mass index [BMI] exceeds 30 [30% overweight] and does not affect the life expectancy particularly in women. This study was conducted to asses the relation of thickness of fat penniculus [obesity] between xiphoid and umbilicus to different atherosclerotic lesions; and to collect basic data about age and sex distribution of this relation. It was prospective descriptive study and conducted at mortuary of King Edward Medical University, and Department of Pathology, Allama Iqbal Medical College, Lahore. A total of 130 human autopsies were carried out in one-and-a-half year of study duration. The ages of the deceased ranged between 8 and 85 years. Heart aorta and its major branches were included in this study. In addition, fat penniculus between xiphoid and umbilicus was measured and atherosclerosis lesions were categorised and correlated with this parameter. Haematoxylin and Eosin, and different special stains were done in Pathology Department of Allama Iqbal Medical College, Lahore to asses to severity of atherosclerosis lesions. The fatty streaks were present in predominantly more cases with Fat Penniculus <20 mm than in asses with Fat Penniculus <10 mm and <30 mm. The fibrolipid plaques, complicated and calcified lesions were present in a dominant number of cases with Fat Penniculus <30 mm on percentage basis. Raised lesions were seen more frequently in cases with Fat Penniculus 20 mm to <30 mm than in cases with Fat Penniculus <10 mm and <20 mm thickness

Differences in detection rates for serious neonatal diseases before and after institution of newborn rounds by paediatricians in a private sector hospital

Perinatal and infant mortality are two major contributors to child mortality in developing world. It is widely recognised that synergistic efforts by paediatric and obstetric healthcare providers result in improvement of neonatal and infant survival. Close working relationship between the 2 disciplines with attendance of all high risk births by paediatric healthcare providers and routine examination of all neonates is required for this purpose. Objectives were to compare 2 continuums of 100 neonatal cases for detection of serious neonatal disease. One set of neonates being examined by neonatal/paediatric service and other without this service in place. One hundred Neonatal Exam sheets were selected randomly from records of 2007-2008 and compared with 100 Neonatal Exam Sheets of 2006-2007. Records were analysed for detection of serious neonatal conditions at 24 hours age. Data was analysed using MS EXCEL. Odds ratio was calculated for each disease with Haldane correction. Odds ratio was significantly higher for detection of serious neonatal diseases in 2007-2008 group when neonatal service was actively involved in newborn examinations of all neonates. Highest odds ratios were obtained for detection of Heart Murmur and neonatal sepsis. Newborn Examination within 24-48 hours of birth by trained neonatal healthcare provider is paramount for adequate detection of serious neonatal diseases. Such services should be instituted in all obstetric units for better neonatal outcome

Effectiveness of routine urine analysis of patient attending rural health centers in Abbottabad

Renal diseases may be discovered accidentally during routine urinalysis. This study was done to see the significance of urinalysis and study the magnitude of abnormal urinalysis in patients with no symptoms of renal disease. From 15th February to 16th March 2005, a total of 1000 samples of urine were collected from the patients attending three rural health centers of Abbottabad. Dipstick Method was used for urinalysis. there were 600 males and 400 female patients. The age ranged from 1 to 55 years. Proteinuria was present in 2.3%, hematuria in 4.8% patients, pyuria in 10.2% and glycosuria in 2% patients. In our setup routine urine analysis should be performed in all patients to identify the presence of unrecognized renal diseases which may benefit from simple therapeutic measures

HbsAg and HCV: Increasing test requests and decreasing frequency of positive tests at clinical laboratory of Ayub teaching hospital, Abbottabad

This audit was carried out to assess the frequency of positive results out of the total test requests made for HBsAg and HCV at our laboratory. The frequencies for three years were compared for significance. We have reported monthly total test requests and frequency of positive tests for each of these years in this article. This study is an audit of all HBsAg and HCV test requests received at clinical laboratory of Ayub Teaching Hospital, Abbottabad during a three year period from 2002-2004. Both the tests were made using Rapid device [immunochromatographic kits] method. Frequencies of positive results were calculated from the total test requests for each month of these three years. Cumulative frequencies were compared for statistical significance of difference. Total HBsAg tests requested for years 2002, 2003 and 2004 were 2058, 2563 and 5207 respectively. The frequencies of HBsAg positive cases out of these were 5.53%, 4.36% and 2.68% respectively. The number of test requests for HBsAg increased significantly from 2002 to 2003 and 2004, while the frequency of positive tests decreased significantly [p<.001] during this period. Total HCV requests for years 2002, 2003 and 2004 were 1261, 1671 and 4638 respectively. The frequencies of HCV positive cases out of these were 14.19%, 8.79% and 5.84% respectively. Just like HBsAg, number of test requests for HCV increased significantly from 2002 to 2003 and 2004, while the frequency of positive tests decreased significantly [p<.001] during this period. Conclusions: The test requests have considerably increased in the last few years, probably as a result of increasing awareness of clinicians and public. However most of these tests are negative. In view of high prevalence of both HBsAg and HCV in Pakistan, this overcautious attitude of clinicians is understandable although this is a burden on the pocket of patients and hospital resources