Journal of Islamabad Medical & Dental College
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Common Radiological Findings in Children with Suspected Foreign Body Inhalation
Get PDFBackground: Aspirated foreign bodies, an emergency situation, affecting children mostly in the first decade of life, either go undetected, are misdiagnosed or discovered unexpectedly. The purpose of this study was to determine the common radiological findings among children with suspected foreign body inhalation at Khyber Teaching Hospital, Peshawar Pakistan.Material and Methods: This cross-sectional descriptive study was conducted at the Department of ENT, Khyber Teaching Hospital, Peshawar, from April 2017 to October 2017. All patients (n=141) were subjected to detailed history and clinical examination. X ray chest (AP and lateral views) was performed to detect common radiological findings i.e., radiopaque foreign body (FB), pneumonia, emphysema, atelectasis and air trapping. The age and gender-stratified radiological findings were analyzed using Chi square test to see effect modifications, with P-value < .05 as statistically significant.Results: In this study, mean age was 8±3.563 years, with most of the children with suspected FB inhalation presenting in the 1-6 years age group (n=82; 58%). Sixty percent children were male while 40% were female, with emphysema (28%) and air trapping (25%) as the most common radiological findings. Radiopaque FB was detected in 16% of children on X-ray chest.Conclusions: Children with suspected foreign bodies should be thoroughly evaluated by both clinical and radiological examination
Ibn-e-Sina’s “Canon of Medicine”
Get PDFPerhaps the most famous philosopher-scientist of a thousand years hence was Ibn-e-Sina (Avicenna) who was born near Bukhara in 980 AD. While his writings on astronomy, Islamic theology, mathematics as well as poetry gained fame, it is for his contribution in medicine that he is remembered
Disease Pattern and Outcome among Neonates in Pediatric Ward of POF Hospital, Wah
Get PDFBackground: Neonatal period is the duration between 0-28 days of birth and it is the most susceptible period of life because of the large number of problems and diseases which a neonate is likely to face. The objective of the study was to determine the disease pattern and outcome among neonates in Pediatric ward of POF Hospital.Material and Methods: A descriptive study was carried out at Pediatric ward of POF Hospital Wah Cantt. Retrospective data regarding age, sex, reasons for admission, outcome and mode of delivery (from hospital record) was collected for all neonates admitted during the year 2016 from 1st January to 31st December. The data was analyzed by using SPSS V-19.Results: Among total neonates (n=887) admitted during the year, 63.2% were males and 36.8% were females. Mean weight of neonates was 2.54 + 0.75 kg while mean age was 2.39 + 5.8 days. Most common diseases were Prematurity, Respiratory Distress Syndrome, Seizures and Sepsis. Overall, 82.64% recovered from their illness while 17.02% expired.Conclusions: Prematurity, respiratory distress syndrome, seizures and sepsis were the major causes of neonatal admission in this study.Key words: Diagnostic value, Immature-to-total neutrophil ratio, Neonatal sepsi
Antimicrobial Susceptibility Pattern among Patients Presenting with Acute Exacerbation of COPD
Get PDFBackground: The irrational use of antibiotics in outpatient as well as indoor patients without studying the culture and sensitivity patterns may have led to resistance in common organisms causing acute exacerbation of chronic obstructive pulmonary disease. The objective of this study was to determine the culture and sensitivity patterns of bacteria in the sputum of patients presenting with acute exacerbation of chronic obstructive pulmonary disease (COPD) in our population.Material and Methods: This cross-sectional study was conducted in the Medicine Department, Jinnah Hospital Lahore from 1st January 2018 to 25th June 2018. A total of 215 patients with acute exacerbation of COPD were collected through non-probability consecutive sampling technique. COPD was diagnosed on the basis of history, examination, chest X-ray and spirometry. Acute exacerbation was taken as an acute rise in one or more of the following; sputum volume and/or purulence, frequency and severity of cough and dyspnea. Two sputum samples were collected from each patient. Antimicrobial susceptibility testing was done as per CLSI guidelines. Data was analyzed by SPSS version 21.0. with p-value ≤ 0.05 considered as statistically significant.Results: Among 215 selected cases, 118 (54.88%) were males and 97 (45.12%) were females. A total of 110 (51.16%) cultures were positive and 105 (48.84%) were negative for bacterial growth. Klebsiella pneumoniae (n=69; 62.72%) was the most frequent microorganism in patient’s sputum followed by Pseudomonas aeruginosa (n=21; 19.1%) and Staphylococcus aureus (n=20; 18.2%). Regarding sensitivity pattern, amikacin was found to be the most sensitive antibiotic against these organisms followed by gentamicin and ciprofloxacin.Conclusions: Klebsiella pneumoniae was the most common microorganism in the sputum of patients presenting with acute exacerbation of COPD, while amikacin was reported to be most sensitive antibiotic against the microorganism.Key words: Acute exacerbation, Antimicrobial susceptibility pattern, COP
Intestinal Malrotation with Midgut Volvulus leading to Small Bowel Obstruction in a Young Adult: A Case Report
Get PDFThe developing intestine rotates around the superior mesenteric vessels during physiological herniation from 6th to 10th weeks of embryogenesis. Intestinal malrotation leading to midgut volvulus and small bowel obstruction is a rare condition. Patients who develop this condition usually present in the first year of their life. Intestinal malrotation is characterized by right sided duodenojejunal junction, caecum in left iliac fossa and a narrow mesentery. Ladd’s procedure is the treatment of choice which is done to restore the normal anatomy. We report the case of an 18-year-old male patient, who presented with intestinal malrotation in emergency department of Nishtar Hospital, Multan. It is an uncommon age for presentation of this anomaly. The patient had fecal peritonitis due to caecal perforation. He underwent Ladd’s procedure in which ileocolostomy was made after right hemicolectomy. The patient had an uneventful recovery after the surgery and had no complaints on follow up visit one week after the discharge
An Experience of Surgical Management of Peripheral Vascular Injuries at Pakistan Institute of Medical Sciences, Islamabad
Get PDFBackground: Peripheral vascular trauma is fairly common and its repercussions lead to need for urgent management and multidisciplinary approach. We hereby evaluate the presentation, management and outcomes of peripheral vascular injuries presenting in a tertiary care hospital in Islamabad, Pakistan.
Material and Methods: This was a prospective clinical study conducted in the Department of General Surgery, Pakistan Institute of Medical Sciences (PIMS) Hospital, Islamabad Pakistan from January 2016 to June 2018. A total of 60 patients with vascular extremity trauma were included in the study. Initial assessment and resuscitation were done and patients with vascular injury were directly shifted to operating room for primary vascular repair (if defect size < 2 cm) or vein graft (great saphenous). Fractures and nerve injuries were also treated. Fasciotomies were performed where indicated. Post-operative monitoring of limb was done for palpable pulses, temperature and color changes. Collected data included age, gender, duration of injury, nature of injury, operative findings, other associated injuries, type of definitive repair, involvement of artery, complications including amputations, infections, re-exploration, ligation or death. Statistical Package for Social Sciences (SPSS) version 23 was used to analyze data.
Results: Out of total 60 patients, 53 (88.3%) were males and 7 (11.7%) were females, with a mean age of 27.8±14.1 years. Most of the patients presented after 6 hours of trauma (n=36; 60%). Blunt trauma accounted for 37 (61.7%) while penetrating trauma was seen in 23 (38.3%) patients. Per operatively, 33 (55%) patients had intimal injury, 7 (11.7%) had partial tear and 20 (33.3%) had complete transection of artery. Primary repair was performed in 9 (15%) patients and reverse vein graft in 51 (85%) patients. Most commonly injured arteries were femoral (n=21; 35%), brachial (n=18; 30%) and popliteal (n=12; 20%) arteries, respectively. Amputations were significantly related to presentation of patients later than 6 hours (P=0.035).
Conclusion: Patients who present with vascular trauma need an early diagnosis, referral and timely management in order to save both limb and life of patients with special concern for good quality of life and cost-effective management
A Review of Child Sexual Abuse in Pakistan Based on Data from “Sahil” Organization
Get PDFChild sexual abuse (CSA) is an unrevealed but an alarming issue in every civilized society. This paper examines the reported incidents of child sexual abuse in Pakistan. Its primary goal is to assess the currently available data on incidents of CSA in Pakistan from 2010 to 2016, while the specific objective is to understand the magnitude, as well as nature and context of the problem. Data on CSA from 2010 to 2016 were collected from the "annual cruel numbers" of the "Sahil" organization, which revealed that incidents of CSA have increased in Pakistan since 2010. The data show that 2,252 incidents of CSA (Boys 606 and Girls 1,646) occurred in 2010 and a larger number, 4,139 incidents (Boys 1,729 and Girls 2,410), occurred in 2016. Most of the survivors belonged to the Punjab province of Pakistan (1,723 out of 2,252 in 2010 and 2,676 out of 4,139 in 2016). Most abusers were acquaintances of their victims (3,964 in 2010 and 1,829 in 2016). The majority of incest cases were observed in 2012 (144 cases). The victim's home was a place of abuse in most incidents (306 incidents in 2010 and 594 in 2016). Government, as well as non-governmental organizations, should raise awareness of CSA. Furthermore, religious leaders must play their role to curb occurrence of CSA by preaching about its religious implications
Prevalence of Speech Sound Disorders among Primary School Children
Get PDFBackground: Communication Disorders are common and affect individual’s abilities to comprehend, detect and use language and speech, with speech sound disorders (SSD) being the most common communication issue of the youth. SSD is a disorder of development with difficulty in articulation and phonology affecting understanding and intelligibility of speech of a child. It affects the scholarly accomplishment in school as well. The objective of this study was to determine the prevalence of speech sound disorders among primary school going children.
Material and Methods: This was a cross-sectional study, recruiting a sample of 377 children through probability sampling technique from May 2018 to December 2018. Students of both genders, aged 4 to 8 years, were enrolled from Government Primary Schools of Mandi Bahauddin District, Punjab Pakistan. Students from private and special schools were excluded. Tool for Assessment of Articulation and Phonology in Urdu (TAAPU) was used to collect data, followed by data analysis using SPSS version 20.
Results: Of 377 primary school children, 167(44.3%) were males and 210 (55.7%) were females with a male to female ratio of 1:1.26. Speech Sound Disorder was detected in 5 (1.3%) children, 4 males and only 1 female. Of these 5 cases with SSD, 3 (60%) males suffered from substitution and 1(20%) from omission, while 1 (20%) female child suffered from substitution disorder.
Conclusion: The prevalence of Speech Sound Disorders in primary school children is very low being 1.3%, with significantly higher prevalence in males aged 61-72 months. “Substitution” of sounds is more common compared to “omission”
Protective Effect of Morus Nigra Leaf Extract on Diazinon-Induced Hepatotoxicity in Rats
Get PDFBackground: Diazinon is a globally used pesticide. Morus nigra (Black Mulberry) possesses flavonoids and phenols, which act as antioxidants. The objective of this study was to determine the possible protective effects of Morus nigra leaf extract on Diazinon-induced hepatotoxicity in rats.
Material and Method: It was an experimental study conducted in the Department of Anatomy, Postgraduate Medical Institute, Lahore. A total of 36 healthy male Wistar albino rats were divided into three groups with 12 rats in each group. Group I was the control group. Group II was treated with 60 mg/kg body weight (bw) Diazinon daily for 4 weeks through orogastric intubation. Group III was treated with Diazinon 60 mg/kg bw daily along with 350 mg/kg bw of Morus nigra extract daily for 4 weeks through orogastric intubation. Blood samples were collected through cardiac puncture, for estimation of alanine transaminase (ALT) and aspartate transaminase (AST) levels. Liver dissection was done, slides of the hepatic tissue were prepared and studied under light microscope. The histology of hepatocytes, portal lobule, portal vein and sinuosoids was observed. SPSS 20 was used for data analysis. One-way ANOVA followed by Tukey’s test was applied to establish difference among groups with P-value ≤0.05 considered as statistically significant.
Results: Histology of Liver tissue in group I showed normal morphology while group II revealed hypertrophy and vacuolization of hepatocytes, congested central vein and sinusoids and presence of necrotic foci. These toxic effects were reversed by the co-administration of Diazinon with Morus nigra in group III which showed normal histology of the hepatic tissue. Similarly, Diazinon administration resulted in significant elevation of ALT and AST levels (P-value<0.05), while, Morus nigra resulted in a considerable decline in the levels of these enzymes (P-value <0.05).
Conclusion: Morus nigra extract has hepatoprotective effects against liver toxicity induced by Diazinon