The Impact of Rigid Cervical Collars on Outcome of Patients Who Underwent Posterior Cervical Laminectomy and Fusion: A Retrospective Comparative Study

Methods@#Patients who underwent PCLF and received postoperative cervical collars from 2018 to 2020 were included in this retrospective cohort study. Their data were compared with an age- and sex-matched group of subjects who did not receive collars after PCLF during the same period. Pain intensity (using the Visual Analog Scale), Neck Disability Index, and quality of life (using 36-item Short Form Health Survey) of the patients were compared at baseline, 1, 3, 6, and 12 months postoperatively. @*Results@#A total of 36 patients who received cervical collars after surgery and 40 controls were included. At baseline and 1-month follow-up, there were no differences in pain intensity, functional status, and quality of life between the groups. However, at 3 months postoperatively, the quality of life of the subjects with no orthosis was higher than those who received cervical collars (p =0.01). At 6- and 12-month follow-up, there were no differences between the groups in pain intensity, functional status, and quality of life. @*Conclusions@#No difference in the pain intensity and functional status of patients who used cervical collars and controls was shown in our study. Patients who did not wear cervical collars had a higher quality of life during the 3-month postoperative evaluation. Future prospective, well-controlled studies with longer follow-ups are needed to further investigate the effects of cervical orthosis on the clinical outcome of patients after PCLF.

Neurological manifestations of HIV-AIDS among HIV diagnosed patients at a tertiary Care hospital of khyber Pakhtunkhwa, Pakistan

Background: neurological manifestations affecting the nervous system at all stages of Human Immunodeficiency Virus [HIV] infection are common. Neurological complications occur in more than 40% of patients with HIV infection. They are the presenting feature of Acquired Immune Deficiency Syndrome [AIDS] in 10-20% of cases. At autopsy the prevalence of neuropathological abnormalities is 80%. Although an ongoing decline in HIV associated Central Nervous System [CNS] diseases has been observed in very recent years, the mortality from these diseases remains high

Objective: to study the type and frequency of different neurological involvements in patients with HIV infection at tertiary care hospital in Peshawar, KPK and to correlate them with CD4 counts

Study design, settings and duration: this retrospective observational study was carried at Lady Reading Hospital, Peshawar, KPK, Pakistan over a period of 8 years from May 2009 to June 2017

Subjects and Methods: a total of 100 HIV sero-positive patients of both genders, aged >18 years, showing clinical evidence of central nervous system [CNS] involvement were included. Their clinical manifestations, laboratory investigations, and neuroimaging were studied. Laboratory investigations along with magnetic resonance imaging [MRI], EEG and nerve conduction study of the brain/spine was also performed

Results: tuberculous meningitis was the most common presentation as secondary CNS illness [49%], followed by cryptococcal meningitis [16%] and cerebrovascular accidents [7%]. Furthermore, 6% had neurosyphilis, 5% had acquired immune deficiency syndrome [AIDS] associated dementia and peripheral neuropathy occurred in 17% of the patients. Headache was the most common neurological symptom seen in 42% of the patients. Seizures were noted in 35% of the patients. CD4 was significantly low in most of the patients with progressive multifocal leukoencephalopathy, HIV associated encephalopathy [HAD] and cryptococcal meningitis compared with other neurological manifestations. CD4 counts in tuberculous meningitis and HIV associated encephalopathy were 115/microl and 83/microl, respectively

Conclusion: CNS tuberculosis was the most common secondary infection seen in HIV patients followed by cryptococcal meningitis. A high index of clinical suspicion of neurological involvement in HIV patients helps in the early diagnosis and early institution of specific treatment, which in turn decreases the morbidity and mortality considerably. Early treatment and prophylaxis of neurological problems in HIV patients is very important to decrease the mortality rate

Stunting among children in district east Karachi, Pakistan

To study stunting problem in children attending schools in District East of Karachi, to calculate prevalence of stunting on the basis of study and compare it with national data and to suggest intervention to prevent stunting in school children. Cross sectional epidemiological study. This study was conducted on the school children of Karachi during February 2012 to February 2013. 164 randomly selected children attending private and government schools in Karachi East. There were 164 total children out of them 81 [49.40%] were male and 83 [50.60%] female. Stunting was present in 101 [61.5%], normal height and weight was observed in 7 [4.26%]. Stunting and not stunting proportion of 164 children among them 101 were stunted and 64 were not stunted [P< 0.05]. The study showed the stunting in Karachi needs nutritional intervention and public health and community health education to halt stunting problem in school health children in Karachi east

Injection sclerotherapy of bleeding gastric varices using absolute alcohol

To evaluate the effectiveness of absolute alcohol injection in the management of bleeding gastric varices. This descriptive study was conducted in the department of Gastroenterology, Hayatabad Medical Complex Peshawar from September 2006 to September 2009. Twenty Seven patients with portal hypertension fulfilling the inclusion criteria and consenting were included in the study. Endoscopy was arranged within 12 hours of admission to the hospital. The gastric varices were injected with 5-10 ml of absolute alcohol depending upon the size of the varices. Both intravariceal and paravariceal techniques were used. Subsequent endoscopy sessions were arranged at 2 weeks intervals. The outcomes assessed were variceal eradication, rebleed and death. Findings were noted and entered into a structured proforma. Data was analyzed using SPSSv.10. Fifteen [55.56%] patients were male and 12 [44.44%] were female with a mean age of 47.52 +/- 15.09 years. Twenty one [77.78%] patients had cirrhosis due to chronic hepatitis C, 4 [14.81%] were HBV related while 2 [7.40%] had alcoholic liver disease. Majority [70.73%] had child's class C followed by B and A [18.51% and 11.11% respectively]. Variceal eradication was achieved in 19[70.37%] patients. Three were lost to follow up while 5 died due to uncontrolled bleeding. Post sclerotheraphy ulceration was the most common complication [64%] followed by pyrexia [28%], Retrosternal/epigastric pain [16%] and dysphagia [8%]. Sclerotherapy with absolute alcohol may be effective in achieving hemostasis in bleeding gastric varices but with exceptionally high rate of complications