Health disparities between Muslim and non-Muslim countries

We examined differences in health indicators and associated factors across countries according to the proportion of the population who are Muslim. Of 190 UN countries, 48 were classified as Muslim-majority countries [MMC] and 142 as non-MMC. Data on 41 potential determinants of health were obtained from 10 different data sources, and 4 primary outcome measures [male and female life expectancy, maternal mortality ratio and infant mortality rate] were analysed. Annual per capita expenditure on health in MMC was one-fifth that of non-MMC. Maternal mortality and infant mortality rates were twice as high in MMC as non-MMC. Adult literacy rate was significantly higher for non-MMC. Four significant predictors explained 52%-72% of the differences in health outcomes between the 2 groups: gross national income, literacy rate, access to clean water and level of corruption

Excessive crying and irritability in infants due to drugs

This study was performed to see the extent and magnitude of drug induced excessive crying in infants and to know the causative drugs, from July 2005 to June 2006. It is a prospective and descriptive study. All children under 1 year of age, who presented with excessive crying of recent onset as the main complaint and were receiving some medicines were included in the study. After getting detailed history [particularly drug history], the problem was explained to the parents, the suspected drug was stopped and the patients were called back for follow up after 48-96 hours. If the crying had not stopped, the diagnosis was reconsidered and patient was excluded from study analysis. If the crying had stopped, it was assumed that the drug was the cause of excessive crying. All the included patients were studied for age, diagnosis, month of the year, geographical origin and the causative drugs. A total of 227 patients were included in the analysis; out of this, 44 [19.38%] were less than imonth of age while 183 patients [80.62%] were above 1 month, 143 patients were suffering from upper respiratory infection and 78 from wheezy chest. Majority of the patients presented during winter months. About 3/4th of the patients were from D. I. Khan district but the remaining 1/4th were from nearby and remote districts like Mianwali and Layyah. Most frequent causative drug was Rondec-D drops [Abbot] in 13o patients. Other drugs were various cough preparations, promethazine [Phenergan], brochodilators, anti-emetics, metronidazole, anti-histamines, various herbal preparations, phenolbarbitone and various anti-diarrhoeals in a decreasing order of frequency. This problem can be reduced by avoiding these medicines in below 1-2 years of age. It is therefore recommended that these above drugs should not be promoted for use in infants and Rondec-D drops and other similar preparations may be withdrawn from the market

Colonic injuries: is primary repair a safe option?

This study was conducted at Mayo Hospital, Lahore from April 2004 to May 2005 to compare the results of primary repair and exteriorization in cases of large gut injuries. 80 patients, presenting in emergency between Jan. 2004 and December 2005, were selected out of which 63 were males and 17 were females. Colonic injuries were divided into five categories and were dealt accordingly. All colonic injuries presenting to emergency in study period except. Injuries requiring ileocolic anastomosis, repair and proximal fecal diversion and distal colonic injuries requiring Hartmann's procedure

Comparison between primary repair and exteriorization in cases typhoid perforation

This comparative study was conducted at Mayo Hospital, Lahore from April 2004 to May 2005 to compare the results of primary repair and exteriorization in cases of typhoid perforation 80 patients were selected out of which 48 were males and 32 were females. Consisted of a history of fever abdominal pain, constipation, sharp shooting pain superimposed over the colicky abdominal pain clinical finding included tense tender abdomen and absent bowel sounds, investigations including gas under diaphragm in abdominal x-ray and positive widal test. Consisted of negative Widal test even if there was gas under diaphragm, per op findings suggestive of tuberculosis or histopathology reports suggestive of tuberculosis or any pathology other than typhoid. Primary repair was done in patients who presented within 36 hrs of experiencing sharp shooting pain and per op findings of minimal contamination. Exteriorization in the form of loop or double barrel ileostomy was done in other cases

Amputations in general surgical practice

Amputation is still often viewed as a failure of treatment. The responsibility for performing an amputation may even fall on the most junior member of the surgical team. Whatever the reason for extremity amputation, it should not be viewed as a failure of treatment. Amputation can be the treatment of choice for severe trauma, vascular disease, and tumors. In our setup amputations for vascular and diabetic complications fall under the domain of general surgeons The purpose of study was to determine the age and sex distribution, incidence of diseases that resulted in amputations, and the level of amputations done in them. A descriptive study on one hundred patients undergoing limb amputations in general surgical practice at department of Surgery, Mayo hospital Lahore. All the patients presented to general surgical emergency/OPD with limb pathology Patients with bone tumors and isolated limb trauma [referred to orthopedic unit]. Most amputations in our study were performed in elderly persons for PVD, Diabetes mellitus being the leading cause