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Rehman M.U.,Bolan Medical College Quetta | Jaffer M.A.,Bolan Medical College Quetta
Pakistan Journal of Medical and Health Sciences | Year: 2016

Aim: To determine the various clinical conditions presenting with bleeding per rectum. Methods: This was a cross section analytical study conducted at Sandeman Provincial Hospital Quetta Pediatric surgical ward from February 2015 to November 2015. A total of 45 patients of either sex from ages of 0ne day to 14 year who presented with bleeding per rectum were included with non-probability convenient sampling technique. Patients were admitted via OPD and emergency. Detailed history and physical examination encompassing the duration and comorbid conditions, per rectal and abdominal examination was performed. Results: 45 patients with bleeding per rectum were evaluated, out of which 2(4.4%) were dysentery, 12 (26%) anal fissure, 10(22%) rectal polyp, 8(17%) intussusception, 5(11%) rectal prolapse,2(4.4%) abdominal lymphoma, 3(6.6%) meconium ileus, 2(4.4%) necrotizing enterocollitis,1(2.2%) rectal mass. Conclusion: Bleeding per rectum is the presenting complaint of a myriad clinical conditions, which should be sought and investigated. © 2016, Lahore Medical And Dental College. All rights reserved.

Saeed S.,Medical College Mirpur | Khan Z.,Medical College MIR Pur Azad Kashmir | Salam R.,Bolan Medical College Quetta | Ahmad A.,Headquarter Hospital Mirpur Azad Kashmir
Pakistan Journal of Medical and Health Sciences | Year: 2016

Background: Hypertensive disorders of pregnancy are responsible for significant maternal and perinatal morbidity and are the second leading cause of maternal mortality. Etiology of PET remain unclear despite extensive research because the disorder is heterogeneous, the pathogenesis can differ in woman with various risk factors. Aim: To compare maternal outcome in PET at altitude >5000 feet with PET at altitude <5000 feet. Methodology: This descriptive case series study was conducted in D.H.Q Hospital Bagh for two years from September 2008 to 2010. Patient with PIH with positive protein urea were included in this study. Total 200 cases were taken 100 from area >5000 feet and 100 from <5000 feet. Incidence of PET, eclampsia, intrauterine growth retardation and pre-maturity were recorded. Results: Patients came from high altitude had adverse maternal outcome when compared with low altitude group. The frequency of severe pre-eclampsia was significantly (<0.05) higher in high altitude group. In high altitude group 62% cases and in low altitude group only 29% cases presented with severe PET. In high altitude group out of these 62 cases, 15 (24%) patients developed eclampsia in contrast to 3 (10%) patients from low altitude group, abruptioplacenta was seen more frequent in high altitude group 16(26%) vs. 4(13%) in low altitude group. The frequency of ARF, 13(21%) vs. 4(13%) cases and coagulopathy 6(9.6%) vs 1(3%) cases was noted significantly (<0.05) more common in patients coming from high altitude. Only 2(3%) cases of HELLP syndrome were seen in high altitude group. The proportion of raised liver enzymes was seen significantly (<0.05) greater in high altitude group. There were 4 maternal deaths in high altitude group, 2 due to eclamptic seizure and 1 case due to coagulopathy and one case due to HELLP syndrome. Conclusion: There is strong association between adverse maternal outcome and high altitude of >5000 feet in term of pregnancy complications in patients of PET.

Iqbal T.,Akhtar Saeed Medical College | Mughal N.M.,Mohi u Din Islamic Medical College Mirpur AJK | Shahwani M.B.,Bolan Medical College Quetta | Dar U.F.,General Motors | And 2 more authors.
Pakistan Journal of Medical and Health Sciences | Year: 2016

Background: Minimally invasive plate osteosynthesis (MIPO) for distal femoral fractures using locking compression plate is used in our local setting but has not been extensively studied in Pakistani population. Aim: To determine the outcome of minimally invasive plate osteosynthesis (MIPO) for distal femoral fractures using locking compression plate. Methods: This descriptive case series study was carried out at Department of Orthopedics. One hundred and fifteen patients with fracture of the distal femur without any breach in skin (closed fracture) were operated using MIPO technique. Radiological union was determined within 12 weeks by X-ray. Radiological bone union was defined as bridging callus across the fracture site on both anteroposterior and lateral radiographs. Functional outcome of patient was assessed by using knee society scores and rated as excellent (91-100), good (74-89) and fair (60-74). Results: One hundred fifteen patients were included in our study with mean age of 43.74±12.88 ranged from 25 to 75 years of age. Seventy six patients (66.1%) were male and remaining 39 patients (33.9%) were female. Among sampled population 106 patients (92.2%) achieved radiological union at 12 weeks. Knee society score of 14(12.2%) was fair, 69(60%) had good and 32(27.8%) with excellent score. Gender and age distribution were similar in both groups with & without radiological union. Conclusion: Outcome of minimally invasive plate osteosynthesis (MIPO) for distal femoral fractures using locking compression plate is satisfactory in terms of union and functionality.

Mughal N.M.,Mohi u Din Islamic Medical College Mirpur AJK | Iqbal T.,Akhtar Saeed Medical College Lahore | Shahwani M.B.,Bolan Medical College Quetta | Dar U.F.,General Motors | And 2 more authors.
Pakistan Journal of Medical and Health Sciences | Year: 2016

Aim: To determine the efficacy of Illizarov hybrid external fixation for Schatzker V and VI tibial plateau fractures secondary to high energy trauma. Methods: A descriptive case series was carried out. Ninety patients with high energy Schatzker V and VI tibial plateau fractures (fracture that relay on the existence of huge degree of articular dispersion, displace multiple condylar fracture line and metaphyseal comminution determined by CT scan of the affected knee joint) were treated using hybrid IIlizarov external fixator and followed for outcome at 12 weeks. It was measured in terms of radiological union, pin tract infection and functional outcome using knee society score and rated as excellent (>90/100), good (74 to 89) and fair (60 to 73) and poor (<60). Results: Eight patients (8.9%) developed pin tract infection. 82 patients (91.1%) had attained radiological union. By functional outcome 22 patients (24.4%) showed excellent results, 56(62.2%) were good, 4 (4.4%) were fair and rest of 8 (8.9%) had poor outcome. Conclusion: Radiological union is excellent as 91.1% achieved radiological union, pin tract infection rate and functional outcome is also acceptable in patients with Schatzker V and VI tibial plateau fractures being treated with hybrid Ilizarov external fixator.

Saleem S.M.,Bolan Medical College Quetta | Al Naeemi A.,Sabiya General Hospital | Tareen M.K.,Bolan Medical College Quetta
Pakistan Journal of Medical and Health Sciences | Year: 2014

Background: Diabetes mellitus is a common metabolic disease all over the world and starts very innocently and progress very vigorously. It effects every part of the body, but adversely target the feet. Like the disease itself the feet problem also starts with small innocent ulcer and progress to lethal gangrene that ends either with amputation, septicemia or death. Aim: To search for avoidable factors in diabetic foot ulcer patients. Methods: This prospective observational study was conducted at Sabiya General hospital, Kingdom of Saudi Arabia, in the emergency room directly Or referred into the Diabetic Clinic, from 20112012. Patients having previous amputation, marioloine ulcer and established gangrene were excluded from the study. Results: Out of 129 patients, 119 patients had significant involvement of fore foot and mid foot was observed, in the study period. 10 Patients were excluded from the study. Patient had history of ulcer more than 4 weeks before consultation. 102 (79%) patients changed their foot wear while 17 patients not. The foot wear changed group got significant earlier healing in 48 weeks time, as compare to those patients who resist change their foot wear. Conclusion: Simple change of local customizes sandal foot wear use, expedites healing of foot ulcer, and may even avoid of recurrence of foot ulcer. Added factor in diabetic foot ulcer is locally used sandal in diabetic patients. Illiteracy adds in poor foot care and wear which is one of the most important causes of diabetic foot ulcer and requires concern for quality, type and size adjustments.

Mobin-Ur-Rehman,Bolan Medical College Quetta | Shaikh I.,Abbotabad Dental College Islamabad | Bazai S.U.,Bolan Medical College Quetta | Shaheen A.,The University of Lahore
Pakistan Journal of Medical and Health Sciences | Year: 2012

Objective: To determine the frequency and susceptibility of organism of bacterial agents responsible for neonatal sepsis. Patients and methods: This cross-sectional descriptive study included 209 patients and done in Nursery Bolan Medical Complex Hospital Quetta between July 2012 to December 2012. The patients any indicative of sepsis like drowsiness, refusal to feed, respiratory distress, temperature instability, cyanosis, seizure or neonates born to mother with maternal peripartum fever 38°C, premature rupture of membranes >18 hours, foul smelling or meconium stained liquor or frequent >3 unclear vaginal examinations were included. The neonates with major congenital anomalies like spina bifida, cleft palate, Down's syndrome were excluded. Results: The mean age of the patients was 10.3 days and male to female ratio was 1.1:1. The significant symptoms were poor feeding which was present in 88.5%, lethargy in 83.3%. The frequency of organisms isolated in blood culture was Pseudomonas 29.7%, Klebsiella 10.5%, E Coli 18.7%, Staph Aureus 29.2%, Enterococcus 16.4% and Streptococcus Pneumoniae 2.4%. Conclusion: The spectrum and susceptibility of organism causing neonatal sepsis is changing and physicians ought to remain on guard.

PubMed | Bolan Medical College Quetta and Mahidol University
Type: Journal Article | Journal: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP | Year: 2016

To determine the prevalence of dental caries and its relationship with dental fluorosis, oral health behaviour and dietary behaviour among 12-year school children in moderate-fluoride drinking water community in Quetta, Pakistan.Cross-sectional study.Government and private schools of Quetta, from November 2012 to February 2013.Atotal of 349 children aged 12-year from 14 randomly selected schools were included. The data collection was done on questionnaire designed for children. Dental caries status was examined by using WHO criteria.Dental caries was found in 81 children (23.2%) with mean DMFT0.61. Boys had 1.6 times more chance to have dental caries than girls. Dental fluorosis was found in 63.6% of children with majority of moderate degree (50.5%). Dental fluorosis status was found significantly associated with dental caries status in children. The children who had mild, moderate and severe fluorosis, had 4 times more chances to develop caries than those who did not have fluorosis. There was no significant association between childrens caries status and use of paste, brushing habit, miswak, and visit to the dentist. The use of pastries and juices had a direct relation with the childrens dental caries status.Dental caries in children of Quetta is not so much frequent as compared to the fluoride deficient countries. However, the high prevalence of moderate dental fluorosis and consumption of pastries and juices resulted in dental caries.

Kasi M.A.,Bolan Medical College Quetta
Medical Forum Monthly | Year: 2015

Objective: To determine the accuracy of High Resolution Computed Tomography in the evaluation of Diffuse interstitial lung disease. Study Design: Descriptive study. Place and Duration of Study: This study was conducted in the Department of Diagnostic Radiology, Pakistan Institute of Medical Sciences, Islamabad during the year June 2008 to December 2008. Materials and Methods: 30 patients were selected from OPD and Emergency department with history, clinical signs and plain chest radiograph suggestive of diffuse lung disease. Multi-slice high resolution spiral CT scanner "Asteion VR" (Toshiba) was used to conduct the study with High Resolution Computed Tomography (HRCT) protocol used in the evaluation of diffuse lung disease. Results: The 30 patients included in this study comprised of 15 male and 15 females with a male to female ratio of 1:1. The mean age of patients was 50.33 years. Cough was present in 100% of patients, dyspnea (83%), hemoptysis (17%), body aches (43%), joint pains (13%), and occupational exposure (23%). Different clinical signs were wheezing (70%), coarse crepitation's (47%) and clubbing (7%). In this study of all 30 patients (n=30) sarcoidiosis was (23%), pneumoconiosis (27%), idiopatfiic pulmonary fibrosis (20%), extrinsic allergic alveolitis (7%), lymphangitic carcinomatosa (10%) and systemic sclerosis (3%). Normal or non-diagnostic chest X-rays were seen in 20% patients which were then diagnosed by HRCT. The inter observer agreement on chest X-rays was found to be around 27% and that of HRCT is 52%. Conclusion: HRCT is the diagnostic tool of choice in the diagnosis of diffuse interstitial lung disease.

Khan S.,Bolan Medical College Quetta | Khalid S.R.,Bolan Medical College Quetta | Shah K.,Bolan Medical College Quetta
Pakistan Journal of Medical and Health Sciences | Year: 2012

Objective: To know the efficacy of Lamivudine as an initial treatment of chronic hepatitis B and to know the efficacy of lamivudine provided in the National Program for Hepatitis. Methods: This study was conducted in the National Program for hepatitis and The Department of Gastroenterology Bolan Medical Complex Hospital Quetta from 12-9-2009 to 15-1-2012. HBsAg and HBV DNA were done from Aga Khan University Hospital Karachi and Shoukat Khanum Memorial Hospital Lahore. 76 consecutive patients 66(86.84%) males and 10(13.14%) females with chronic HBV infection were included in the study and treated orally with Lamivudine100 mg once Daily for 6 months to 1 year. All patients were HBsAg positive, HBeAg positive / negative for at least 6months before screening and active liver disease. The male to female ratio is very high. The majority of the patients were belonging very poor socioeconomic group and lower middle class .this is why because the treatment was free and the investigations were funded by the Zakat Fund. Results: 76 patients 66(86.84%) males and 10(13.14%) females were included in this study. Early virological Response (EVR) (DNA not detected after 12 weeks of therapy) was achieved in 14(21.21%) in male patients and 5(50%) in female patients. In Non Responders (HBV DNA detected after 3 months of treatment) the 8(12.12%) patients were males and 1(10%) patients were Female.18(27.27%) male patients and 3(30%) female patients were absconder End of the treatment Response was 32(48.48%) in male patients and 5(50%)in female patients.16(24.24%) male and 2 (20%) female patients are under treatment. No any side effect of lamivudine was observed or reported in any patient during this trial. Conclusion: The male to female ratio in this trial is very high. The Response of hepatitis B to Lamivudine in both the gender is almost the same, and response is directly proportional to the duration of the therapy which is quite comparable to the fact proved in the previous trials conducted on National and Iternational level. So to achieve a complete SVR, the duration of lamivudine may be increased to 3-5years or life long in some very resistant cases.

Memon Q.-U.-N.,University of Hyderabad | Alizai K.A.,Bolan Medical College Quetta
Medical Forum Monthly | Year: 2013

Objectives: This was a cross sectional study aimed to assess differences in tooth size ratio between male and female patients reporting to OPD of orthodontic department L.U.M.H.SHyderabad/ Jamshoro. Study Design: Cross sectional study. Place and Duration of Study: This study was conducted at the Dental OPD of Orthodontic Department,Liaquat University of Medical & Health Sciences, Hyderabad/ Jamshoro. Materials Methods: The study was carried out on 100 (50 male, 50 female) study casts. Criteria for selection of the study casts were pretreatment orthodontic casts with neutral occlusion (Angle Class I) and fully erupted permanent teeth with no dental anomalies. The individual mesiodistal tooth size was measured with a Boley's gauge. The mean and standard deviation were calculated for the size of the teeth and the interarch tooth width ratios both anterior and overall. Results: The ratios for the tooth size were compared to the original Bolton ratio. The overall ratio was found to be 91.42 almost equivalent to the original Bolton ratio of 91.3, whereas the anterior ratio was found to be 79.02, higher than the 77.1 as calculated by Bolton. The mean values for the overall and anterior ratio for the male and female subjects determined which were not statistically significant. Standard deviations for overall & anterior ratio were larger than the Boltons' value. Conclusion: There were no significant differences between the mean overall and anterior tooth width ratio of males and females. Even though the values are not significantly high, a careful analysis of interarch tooth size relationship (Bolton's ratio) should be added along with other diagnostic considerations before initiating orthodontic treatment for better finishing and stability.

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