OptiCard: an inexpensive and portable method of bedside direct fundoscopy

The use of fundoscopy to observe and grade retinal changes in diabetes and hypertension is well known. Fundus screening is recommended prior to discharge of every neonate from the neonatal unit to rule out congenital cataract. However, the traditional direct fundoscopes are expensive and, therefore, not available in majority of the hospitals in developing countries. Also, fundoscopy needs special expertise to use the device. OptiCard is an inexpensive new method of direct fundoscopy that allows visualization of retina and optic disc with or without the use of cell phone. The affordability and ease of use of this device can result in better patient care in hospital setups with limited resources

Hematologic adverse effects and efficacy monitoring in chronic Hepatitis C patients treated with interferon and ribavirin combination therapy

180 million people are affected by chronic Hepatitis C Virus infection globally and more than 50 million in South East Asia. Combination of Interferon and Ribavirin is the current anti-HCV therapy in practice and is associated with certain hematologic adverse effects. In this concurrent observational study the incidence rate of major hematologic adverse effects and efficacy outcomes of Interferon and Ribavirin combination therapy was evaluated in 288 chronic hepatitis C patients at Lahore General Hospital. Levels of Hb, TLC, and Platelets counts were monitored for hematologic adverse effects monitoring, whereas, ALT, AST and bilirubin levels were monitored for efficacy. PCR was done at week 4, 12 and 36 for therapeutic success evaluation. A significant reduction in Hb levels [p<0.05] was observed after week 4, 8 and 12 of therapy. Frequency of anemia increased in both genders with body weight <65kg and platelet count <150,000/mm3. End Treatment Response [ETR] was achieved in 64.5%. Anemia was the major side effect of the combination therapy particularly in the males. Higher ETR was observed in patients who achieved RVR and were <50 years of age

Management of congenital talipes equinovarus by the ponseti method - short-term and intermediate effectiveness of the technique and factors affecting outcome

Objective: To evaluate the effectiveness of the Ponseti method of clubfoot management in neonates and infants and to see which factors affect outcome

Study Design: Retrospective study

Place and Duration of Study: Department of Paediatric surgery, Military Hospital, Rawalpindi, from October 2012 to September 2014

Material and Methods: The Ponseti method for the management of congenital talipes equinovarus was applied in children of 7 days to 6 months age. While those with complex neurological problems, pathological clubfeet, syndromic clubfeet and older than 6 months at the time of presentation were excluded from the study

Assessment was done at presentation, at the removal of the last plaster cast and after one-year use of the foot abduction splint

Results: A total of 124 clubfeet of 89 children, including 63 males [70.78%] and 26 females [43.82%] were treated as outdoor cases. Eighteen feet [14.51%] were of rigid [typical] type whilst 106 [85.5%] were of flexible [typical] type. Bilateral involvement was seen in 35[37.31%] children. The mean pretreatment Pirani score was 5.4 and the mean number of plaster casts required was 5.8

The mean Pirani score at 1-year follow-up was 0.5 with successful outcome in 82.3 % of all cases [96.9 % of neonates]. Poor compliance with the use of the foot abduction splint adversely affected outcomes

Conclusion: The Ponseti method of treatment of congenital clubfeet is safe and easy to learn with effective and reproducible results. Early start of treatment and compliance with the use of the foot abduction splint during the maintenance phase are crucial to successful outcome

Prevalence of contraceptive practices in married women of Nainsukh village near Lahore

Overpopulation is one of the biggest problems faced globally by many developing countries which include Pakistan as well. Pakistan is the seventh most populous country of the world. By 2050 Pakistan will be ranked as the fourth largest nation of the world and its population will grow to 285 million. This study was planned to evaluate the prevalence of contraceptive use in a semi urban area Nainsukh near Lahore, Pakistan and to find out the major factors playing role in selection of contraceptive method. The contraceptive prevalence rate was 35.2% among married females of Nainsukh. It was observed that the most common method used by couples was condom used by 11.70% of the respondents. OCP were used by 4.6%, IUCD by 6.5%. Tubal ligation was opted by 4.6% of the participants. Major source of information was family planning center for 24.8% and friends gave this information to 14.98% of the women. Mother in law 5.9%, dai 9.1%, media 7.8% were other sources. Mean duration of use of contraceptive method was reported to be 2.45 +/- 1.81 years. The most common reason of not using any contraceptive method was lack of awareness 29% and religious beliefs 23%. Approximately 58.3% of the clients were getting contraception facilities from private sector. Source of supply was lady doctor for 6.2% and LHW by 5.2%. About 5.5% of the females reported abortion as a choice to be used for contraception and only 4.2% were aware of emergency contraceptive methods