Seroprevalence of pediatric malaria in Quetta, Balochistan, Pakistan

Malaria is one of the most devastating protozoal diseases in under developing countries like Pakistan where health facilities are scarce. It is the second most frequently reported disease with 4.5 million suspected cases in Pakistan. The current study was designed to determine the incidence of pediatric malaria in Quetta, Balochistan. The study was conducted at Children Hospital Quetta [CHQ] during July 2011march 2012. Blood samples were collected from 3418 clinically suspected and were evaluated using thin and thick blood films stained with Giemsa stain. Out of 3418 total of 230 [6.72%] children were found positive for any of the malarial parasitic infestation. Plasmodium vivax was observed to be more common 54.34% [n= 125/230] than P. falciparum 44.78% [n=103/230]. Male children were 65.21% [150/230] i.e. two times more commonly affected than female 34.78% [80/230] children. The prevalence among age groups was 7.41% [n=89/1200] in preschool-aged children aged 1-5 years, 7.11% [n=75/1054] in school-aged children aged 6-10 years while 6.78% [n=46/678] in 11-15 years-old children, and 6.66% [n=20/300] in >15 year-olds children. Peak prevalence was noted in summer and mild in winter. Mixed infection of [0.86%: 2/230] P. vivax and P. falciparum was also observed in two cases although no case of P. malariae or P. ovale infection was seen during entire study. The results reflect the higher prevalence of malaria in Quetta, Pakistan that poses a significant health threat and requires urgent attention of high-ups to launch programme to control the disease in the area.

Angioedema por uso de inhibidores de la enzima convertidora de angiotensina en otorrinolaringología / Angioedema by users of inhibitors of the angiotensin converting enzyme in otorhynolaryngology

Se presenta una revisión de los casos de angioedema asociado al uso de Inhibidores de la Enzima Convertidora de Angiotensina de nuestro hospital. El objetivo es dar a conocer esta patología a la comunidad médica. La edad promedio de presentación fue de 67,8 años. Los pacientes tomaron el medicamento por entre 1 y 96 meses, antes de la aparición de los síntomas. La cantidad de episodios de angioedema antes del diagnóstico fue entre l y 7,el seguimiento después del tratamiento, entre 8 y 18 meses. El síntoma más frecuente fue edema lingual, aunque una paciente requirió tratamiento en la Unidad de Cuidados Intensivos con intubación orotraqueal. Se presenta una revisión de la literatura, con énfasis en la epidemiología, diagnóstico, mecanismo fisiopatológico y tratamiento de la enfermedad.

Influence of different oil types on the rheological behaviour of nonionic oil -in- water microemulsion

Microemulsions were formed at very low oil concentration in the ternary systems. These solutions are optically isotropic with low viscosity. The rheological behaviours of microemulsion of glucopone-water-hydrocarbon systems were investigated. Four different types of hydrocarbon namely heptane, octane, dodecane and tetradecane were considered. The frequency dependent storage and loss modulus were investigated below the critical strain. The critical strain is decreased as the alkane chain lengths increased. The zero shear viscosity was found to increase when longer hydrocarbon chain lengths were considered. However, when surfactant concentrations were further increased, the value of the zero shear viscosity appeared to be going down as the alkane chain length was increased. The discrepancy between the elastic and loss modulus in heptane and octane systems was higher than that corresponds to dodecane and tetradecane systems. The complex viscosity increased as alkane chain lengths of the hydrocarbon increase. In general, the effects of different types of hydrocarbon in the rheological behaviours were found to be more profound in the heptane and octane systems than in the dodecane and tetradecane systems

Cerebral palsy: comprehensive review and update

Cerebral palsy [CP] is a common pediatric disorder occurring in about 2 to 2.5 per 1000 live births. It is a chronic motor disorder resulting from a non-progressive [static] insult to the developing brain. CP is the clinical presentation of a wide variety of cerebral cortical or sub-cortical insults occurring during the first year of life. The commonest cause of CP remains unknown in 50% of the cases; prematurity remains the commonest risk factor. Children with CP suffer from multiple problems and potential disabilities such as mental retardation, epilepsy, feeding difficulties, and ophthalmologic and hearing impairments. Screening for these conditions should be part of the initial assessment. The child with CP is best cared for with an individualized treatment plan that provides a combination of interventions. This requires the provision of a number of family-centered services that make a difference in the lives of these children and their families. Management of spasticity can be challenging with a wide variety of possible therapeutic interventions. The treatment must be goal oriented, such as to assist with mobility, reduce or prevent contractures, improve positioning and hygiene, and provide comfort. Each member of the child's multidisciplinary team, including the child and both parents, should participate in the serial evaluations and treatment planning

Titrated cyclocryopexy - a report on long term results

To determine the efficacy and safety of a titrated cyclocryopexy in advanced glaucomatous eyes in term of intraocular pressure control and complications. Retrospective Cohort analysis of a titrated cyclocryopexy in 30 eyes of 25 patients with uncontrolled glaucoma during July 1996 to July 2003 at Hayatabad Medical Complex, Peshawar. Inclusion criteria applied was; patients having uncontrolled IOP with maximum medical therapy, previous trabeculectomy and a minimum follow-up of 2 years. All patients were assessed for glaucoma. Numbers of cryoapplications were determined according to the IOP. Four to 12 applications in one sitting were used. Repeat cryoapplication were applied at least after six-weeks of previous therapy if IOP was not controlled. A total of 30 eyes of 25 patients were studied. IOP control of less than 21 mm Hg was achieved in 83% of the eyes. Mean IOP was reduced from 29 ' 4.96 pre-op to 17 ' 7.36 at two years follow-up. Forty percent of the eyes ne eded single session, 40% received 2 sessions and other 20% needed sessions. All the patients lost at least one line of Snellen chart at 2 years follow-up, 70% retained useful vision, 20% retained light perception and 10% lost perception of light. Serious complications included phthisis, persistent vitreous hemorrhage with retinal detachment, and total retinal detachment and persistent vitreous hemorrhage in 1 eye each. Cyclocryopexy appears to be an effective procedure in cases of advanced glaucoma with an acceptable risk / benefit ratio. If done in a titrated manner the number of complications are reduced in severity

Radio-quimioterapia concomitante en cáncer escamocelular avanzado en cabeza y cuello / Concomitant radio-chemotherapy in advanced head and neck squamocellular cancer

La radioquimioterapia concomitante aparece en los últimos años como una alternativa en el manejo de los pacientes portadores de cáncer avanzados de cabeza y cuello. En el Servicio de Otorrinolaringología del Hospital Carlos Van Buren planificamos un protocolo de estudio en pacientes portadores de cáncer escamocelular avanzados de cabeza y cuello, consistente en radioquimioterapia concomitante, 2 Gy diarios por 5 días semanales, completando 6600 a 7000 rad. asociado a cisplatino en dosis de 100 mgr/m² cada 21 días por 3 veces (los días 1,22 y 43). 30 pacientes se incluyeron en el estudio. 28 fueron analizados: 25 hombres y 3 mujeres. La edad promedio fue de 64 años. 8 casos correspondían al estadio III y 20 a estadio IV. 12 casos de localización en hipofaringe, 8 en laringe, 4 en orofaringe, 3 en cavidad oral y 1 en pirámide nasal. Se observó respuesta completa en 18 pacientes (64 por cientos), respuesta parcial en 9 pacientes (32 por ciento) y no respuesta en 1 paciente (4 por ciento). La sobrevida general fue de un 64,3 por ciento. La toxicidad renal y hematológica fueron los efectos adversos más comunes

Assessing parental expectations and satisfaction in a pediatric hospital setting

the purpose of this study was to measure parental expectations and satisfaction in the pediatric unit of our hospital and to explore factors that may contribute to an unfavorable experience. interviews with the parents of children admitted to the pediatric unit were conducted on the day of discharge. A structured 36-item questionnaire was designed to examine areas of parental expectations and reactions to the care provided by the hospital. during the study period, 88 randomly selected individuals were interviewed. This represented 17% of the 512 children discharged during this time. In 86% of the cases, the mother was interviewed. Most of the parents [92%] were entirely satisfied with the care received, and 81% felt that the experience was better than they had anticipated. More parents were satisfied with physician care [93%] than with nursing care [72%, p=0.001]. Fewer were satisfied with the explanations provided for investigations [78%] and treatment [69%]. The discharge plan was clearly explained according to 94%. Only 7 parents [8%] reported inconveniences related to the presence of medical students. This correlated with the child's age being less than 1 year [p=0.007] and the chronicity of the disease [OR=7.6, 95% C.I. 1.1-83]. this study shows high percentage of parental satisfaction of the pediatric care, which mainly was of physician care. The main cause of dissatisfaction was the presence of medical students, especially in the case of a young child [<1y], or chronic disease

Osteosarcoma mandibular / Mandibular osteosarcoma

Se presenta el caso de una paciente portadora de un Osteosarcoma Mandibular tratado en nuestro servicio. Se hace una revisión de dicha patología en cuanto a sus características generales, diagnóstico, histopatología, factores pronósticos y alternativas terapéuticas

Sarcoma sinovial en cabeza y cuello / Synovial sarcoma in head and neck

El presente trabajo analiza una patología de escasa incidencia en cabeza y cuello: el sarcoma sinovial. Se hace una revisión en cuanto a sus características generales, histopatología, clínica, diagnóstico y alternativas terapéuticas. Se presenta un paciente de nuestro servicio portador de un sarcoma sinovial de faringe.

Immunological status in patients with malignant tumours

Forty patients with malignant tumors [Lymphoma 14, leukemia 12 and carcinoma 14] and 40 controls matched for age and sex were tested for their cellular immune response by using Dinitrochiorobenzene [DNCB], purified protein derivative of tubercle bacilli [PPD] and Candida extract antigens. Following sensitization with ONC8 11% of all the patients displayed a delayed cutaneous hypersensitivity reaction [DCHR] as compared to healthy controls of which 65% showed DCHR. Of all the patients only 40% reacted to Candida extract and PPD as compared to controls with a 100% positive reaction. Humoral immune response estimated .with .microim-muno-electrophoresis technique .revealed a significant increase in IgG and IgM. Total proteins in patients with lymphomas as well as alpha, beta and gamma globulins were significantly increased