Pain relief in neuropathic pain-a comparison between 0.5% bupivacaine and 0.5% bupivacaine streptomycin combination

Objective: To compare the effectiveness of a combination of streptomycin and bupivacaine for the management of neuropathic pain against bupivacaine alone

Study Design: A randomized controlled double blinded trial

Place and Duration of Study: Pain clinic Combined Military Hospital [CMH] Rawalpindi, CMH Nowshera, Dermatology Dept. Military Hospital [MH] Rawalpindi, Department of Medicine, Surgery CMH Nowshera Feb 2009 to Feb 2010

Material and Methods: Fifty patients with post herpetic neuralgia [PHN], 10 patients with trigeminal neuralgia and 20 patients with nerve entrapment pain were included in the study. For each type of neuropathic pain, the patients were randomly divided into two groups. Group [B] received nerve blocks using 0.5% bupivacaine and group [BS] received nerve blocks using 0.5% bupivacaine and streptomycin Igm combination. A series of four nerve blocks on alternate days were given. VAS [Visual Analogue Scale] was recorded at four, eight and twelve weeks after the last nerve block. Mean baseline VAS and at 12 weeks post treatment in groups B and BS were compared for pain relief and the mean VAS at 12 week post treatment in both the groups was compared for the difference in pain relief between the two groups. Students't test was used for statistical analysis utilizing SPSS 10 versions

Results: Post herpetic neuralgia - group [B]: at 12 weeks, mean VAS was 5.75 in gp [B] and 2.26 in gp [BS] respectively. Nerve entrapment pain- group [B] at 12 weeks, mean VAS was 6.62 whereas in group [BS] VAS was 1.33. Trigeminal neuralgia-group [B] At 12 weeks mean VAS was 7.0. gp [BS] mean VAS was 1. Pain relief achieved was excellent

Conclusion: Streptomycin and bupivacaine combination is an effective modality to manage neuropathic pain. The pain relief achieved by streptomycin-bupivacaine combination is superior to that achieved with bupivacaine alone

Frequency of ABO blood groups and RhD factor in the female population of district Peshawar

To determine the frequency of ABO blood group and Rhesus [Rh] D antigen in the females of "District" Peshawar, Khyber Pakhtunkhwa Province, Pakistan. This cross-sectional study was conducted on 429 women having pregnancy induced hypertension, admitted in the three teaching hospitals of Peshawar, over a period of one year. Blood sample was collected from each subject after taking informed consent. The antigen antibody agglutination slide test for "blood grouping [ABO]" and RhD factors was done by using IgM and IgG monoclonal reagents. The antisera used were from Biolaboratory, USA. Data was analyzed for percentage calculation. The blood group distribution was 134 [31.2%], 43 [10.1%], 116 [27%], 136 [31.7%] for blood groups A, AB, O and B, respectively. Subjects having blood group B was slightly more dominant, followed by A and O, while blood group AB was rare in these females. Blood group A Rh negative is more in female 12 [37.5%] followed by group O 10 [31.3%], group B 09 [28.1%] and group AB 01 [3.1%].Frequency of "Rh-positive blood group" is B, A, O and AB, whereas the frequency of the most common Rh-negative blood group are A, O, B and AB respectively. The determination of the frequency of blood groups in the region would not only help in blood transfusion services, but also reduce the risk of erythroblastosis foetalis in the neonates

Depression among patients with type-II diabetes mellitus

This study aimed to determine the frequency of depression among patients with type-II diabetes mellitus in Peshawar at Khyber Teaching Hospital, Peshawar, from March to September 2010. Depression was assessed by using Beck Depressive Inventory-II [BDI-II]. Out of 140 patients with type-II diabetes, 85 [61%] were women and 55 [39%] were men. Mean age was 45 +/- 7.45 years. Eighty four [60%] patients presented with severe depression. Depression was higher in females than males and widows. Depression was high in diabetic patients, especially in females and widows. It is of essence that psychiatric attention may be necessary to be incorporated in diabetes care both for prevention and treatment

Comparison of efficacy of injection diclofenac sodium alone and with combination of phoroglucinol in the treatment of acute ureteric colic

To compare the efficacy of diclofenac sodium alone and with combination of phioroglucinol in the 4reatment of ureteric colic. This Quasi-experimental study was carried out in the Surgical Department, Combined Military Hospital, Kharian during the period from June 2006 to December 2006. A total of 60 cases of acute ureteric colic entered the study. Pain scores were measured both on 100 mm visual analogue scale and on categorical verbal scale as baseline and at 15, 30, 45, 60 and 120 minutes after administering the study drug, duration of analgesia was also noted. The efficacy of both the treatment groups was assessed by calculating the difference in mean pain scores, by noting the time when complete pain relief was achieved, by the duration of analgesia and by comparing the response of he drug. Mean pain score in patients treated with combination was significantly less than patients treated with diclofenac sodium alone [p<0.05]. Combination of diclofenac and phloroglucinol was better than diclofenac alone in achieving rapid and complete pain relief

Surgical outcome after femoral vessels ligation in I/V drug users

Intravascular drug abuse is being practiced with increasing frequency in our country, resulting in dreadful complications. A common complication of intravenous drug users is traumatic damage to tissues and organs secondary to injections, which depends on a number of factors which are difficult to quantify, local drug practices, the skill of the injector and the susceptibility of the individual

Objective: To study the incidence, limb complications and indications for limb amputation in intravenous drug abusers

Methods: A descriptive study on nineteen intravenous drug abusers was carried out at department of Surgery, Mayo hospital Lahore

Results: Entire limb survived in Eleven patients, Four had toe amputations, Three ended in below knee amputation and One in above knee amputation

Conclusion: Most of the affected limbs can survive despite the major vessels being tied due to development of collateral circulation