Anxiety symptoms in patients with conversion disorder

Objective: to determine the frequency of anxiety symptoms in patients with conversion disorder

Methodology: this cross sectional study was conducted in Department of Psychiatry, Khalifa Gul Nawaz Hospital Bannu from August 2014 - March 2015. Sixty consecutive indoor patients of conversion disorder, diagnosed on the basis of ICD-10 criteria were assessed in detail. A semi-structured interview was conducted for demographic details

Results: among Sixty indoor patients, 52 [86.6%] were females, thirty six [66%] unmarried and more than 80% [n=50] were uneducated. Similarly, about 89% [n=54] belonged to the age range between 10 and 30 years. Large majority [n=56, 93.3%] were residing in the rural areas. All patients [100%] reported somatic anxiety symptoms along with clinical presentation of conversion disorder. Most common symptoms reported were feelings of being light and weak [n=59, 98.3%], followed by palpitation [n=58, 96.6%]

Conclusion: patients with conversion disorder need to be assessed in detail for somatic anxiety symptoms in order to improve upon intervention strategies in this common psychiatric disorder

Pattern of indications of flexible bronchoscopy among adult patients in a tertiary care hospital

Background: Flexible fiber optic bronchoscopy is frequently performed procedure in pulmonary medicine

Objective: To determine the Clinico-radiological indications of flexible bronchoscopy in a tertiary care hospital

Materials and Methods: This descriptive study was conducted in the bronchoscopy suit of pulmonology department post graduate medical institute[PGMI], Lady Reading Hospital, Peshawar from Jan 2008 to Dec 2010. This was a retrospective analysis of the well maintained records of patients in whom bronchoscopy was done in the above mentioned duration. All the patients above 15 years were included. All the bronchoscopies were done by expert brochoscopists under local aneasthesia. Data was analyzed by SPSS 13 to find the frequencies and percentages

Results: Total number of patients were 423, with a male to female ratio of 1.6:1, in which 191 had haemoptysis , 115 presented with chronic cough, 42 had shortness of breath [SOB] , 11 presented as superior venacaval [SVC] obstruction, 25 had lobar or full lung collapse on chest x rays and 9 patients had solitary or multiple nodules, 8 were scoped for removal of foreign bodies, 4 for medical fitness and 2 for persisted fever. After analysis of x-rays of proven malignancies out of 60 patients, 20 [33.33%] had right side non-resolving consolidation, 18 [30%] Left side consolidation,08 [13.4%] presented with hilar mass, 03 [5%] with multiple nodules, 04 [6.66%] with mediastinal widening , 03 [5%], with left sided lobar collapse, 02 [3.33%] with right lobar Collapse and 02 [3.33%] had either side full lung collapse

Conclusion: Bronchoscopy is an important tool for the diagnosis of the cause of radiological/clinical findings like haemoptysis, chronic cough, SOB, SVC obstruction, hoarseness of voice and persistent x-ray opacity, or lobar or lung collapse. Heamoptysis and chronic cough are the main indications in our setting. Bronchoscopy is minimally invasive procedure with high diagnostic yield for bronchogenic tumours especially central

Pattern of dyslipidemia in adult diabetic subjects in the community hospital of district Swat

The incidence of diabetes is growing at dramatic rates around the word and its complications are associated with significant health and financial burdens, warranting strong and comprehensive prevention efforts. The objective of the present study was to evaluate the pattern of dyslipidemia in the adult diabetic patients in Saidu Teaching Hospital, Saidu Sharif, Swat. The study comprised of 100 subjects, 50 subjects with diabetes and 50 [non-diabetic] controls. The serum Cholesterol, Triglycerides, High-density Lipoprotein-Cholesterol [HDL-C] and Low-density Lipoprotein-Cholesterol [LDL-C], blood sugar [random and fasting], blood pressure [systolic and diastolic] of Diabetic subjects were compared with Control subjects. Diabetic subjects had high mean value of Triglycerides and LDL-C [but statistically nonsignificant], low level of HDL-C [statistically highly significant] and high blood pressure as compared to Control subjects. Dyslipidemia is a potent predictor of cardiovascular morbidity and mortality in diabetic patients

Common trend of antibiotics usage in a tertiary care hospital of Peshawar, Pakistan

Antibiotics are used to eradicate the pre- and postoperative infections in surgical procedures and in all others medical cases. However, inappropriate and indiscriminate use of antimicrobial agents can potentially have a number of problems. The emergence of antimicrobial resistant bacteria, an increased number of patients experiencing adverse drug events, and increased drug-related cost have been documented. The objective of the study was to determine the trend of use of antibiotics and hospitalisation of patients in various units of a tertiary care hospital, to investigate practice variation of antimicrobial agents within the hospital, and to identify and document any opportunity for its improvement. A questionnaire containing relevant information about the study was prepared. Patients' age, sex, diagnosis, duration of hospital stay and type of antibiotic used were recorded and analysed, with particular reference to antibiotic group and disease pattern, in 3 different treatment areas of Hayatabad Medical Complex [HMC], Peshawar, Pakistan, from July 2006 to June 2007. During the period under report, a total of 519 patients were studied for their disease and the type of antibiotics used. The leading type of antibiotics reported were 3rd generation antibiotic used on 147 [28.33%] patients in the 3 units collectively, 1[st] generation 127 [24.47%], and penicillin 99 [19.08%], while macrolides were the least used. The available resources are needed to be effectively utilised, to minimise the hospital stay due to rational use of antibiotics, and to minimise burden of antibiotics on poor patients

Relationship between blood groups and male infertility

Blood is man's complete and unchangeable identity. The ABO and Rh groups are recognised as major and clinically significant blood groups. Blood group antigens are not only important in relation to blood transfusion and organ transplantation, but also have been utilised in genetic research, anthropology and tracing ancestral relation of humans. The objective the present study is to examine the blood group antigens in infertile men for assessing the relationship to male infertility and to know the frequency of various blood groups among infertile males in our population. A total of 1,521 patients along with 460 proven fathers as controls were recruited for the present study from both rural and urban areas of Pakistan and referred to Department of Reproductive Physiology/Health, Public Health Divisions, NIH, Islamabad, during 2002 to 2006. Blood grouping [ABO] and Rhesus factors [Rh] was done by the antigen antibody agglutination test. Overall distribution of blood groups in the studied population of 1,521 subjects was 35.50%, 28.27%, 26.89% and 9.34% for blood groups O, B, A and AB respectively. The ratio of control to patient was 1:3.3. The present preliminary study revealed that in our population the prevalence of male infertility in blood group O is invariably higher than in all other ABO blood groups, showing a strong relationship between blood group O and male infertility

Evaluation of effects of clomiphene citrate on serum testosterone and FSH levels and seminal parameters in idiopathic oligospermia

Clomiphene citrate is a synthetic nonsteroidal drug that acts as an antioestrogen and competitively binds to oestrogen receptors in the hypothalamus and pituitary. This blocks the action of the normally low levels of oestrogen on the male hormone axis and results in increased secretion of GnRH, FSH and LH. The enhanced output of these hormones increases testosterone production and sperm production. A non randomised clinical trial was conducted in a sample of 21 idiopathic oligospermic men from local population with a mean age of 27.75 +/- 4.13 years, to evaluate the effects of clomiphene citrate in a dose of 100mg/day for five days, on serum testosterone, serum FSH, semen volume, sperm density, and total sperm motility. After clomiphene citrate therapy, mean serum testosterone level showed highly significant increase [p<0.05], mean serum FSH level showed significant increase [p<0.1]. Semen analyses were done at periodic intervals, 1[st] at day 1 i.e. before the 1[st] dose of clomiphene citrate, 2[nd] at 6[th] day i.e. 24 hours after the last dose of clomiphene citrate, and 3[rd] at 74[th] day of the trial. Clomiphene citrate administration resulted in statistically significant increase in the mean semen volume at day 6 [p<0.05], increase in the sperm density at day 74 [p<0.05], and increase in the total sperm motility at day 6 [p<0.05]