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Peshāwar, Pakistan

Arif M.,Kust Institute of Medical science | Islam Z.,Khyber Girls Medical College
Canadian Journal of Ophthalmology | Year: 2010

Objective: The objective of this study was (i) to identify clinicopathological variables that significantly influence the frequency of postenucleation orbital recurrence and (ii) to create an awareness regarding follow-up, to pre-empt orbital recurrence. Design: Retrospective, case-controlled, longitudinal study. Participants: A total of 176 children with retinoblastoma who were admitted and treated at Khyber Teaching Hospital between August 1, 1978, and July 31, 1998. Methods: This study was undertaken by reviewing the appropriate charts. The data of children with primary enucleation were analyzed to extract cases of orbital recurrence. Results: The mean age was 3.8 years (range 1-10 years). Of 176 patients, 83 (47.3%) presented with proptosis and fungating mass. Of 136 patients who were enucleated, 80 (58.82%) presented with proptosis and fungating mass. The 31 patients who had been diagnosed as having had orbital recurrence had a mean age of 4.09 years. The duration between enucleation and orbital recurrence was 1-12 months in 28 patients (90.4%). Histopathology reports of only 8 patients (26%) could be traced. Follow-up was recorded in only 9.6% of cases. Conclusions: The failure to identify clinical and pathological parameters in the course of the disease in retinoblastoma children results in human misery caused by poor follow-up and gross negligence.

Zaman A.,Khyber Girls Medical College
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2011

Spontaneous bacterial peritonitis is one of the most frequent and serious complication in patients with liver cirrhosis and ascites associated with high mortality. Empiric antibiotic therapy should be initiated before the results of ascitic fluid cultures are available, guided by knowledge of the microbial spectrum of spontaneous bacterial peritonitis in a particular population. This is a descriptive study which was carried out in the Department of Gastroenterology and Hepatology, Postgraduate Medical Institute Hayatabad Medical Complex, Peshawar from January 2007 to December 2007. Fifty consecutive patients of established cirrhosis liver with ascites presenting with suspicion and or risk factors for spontaneous bacterial peritonitis were included in the study after informed consent. All selected patients were subjected to ascitic fluid tap. Twenty ml of ascitic fluid was aspirated in a heparinised disposable syringe; out of it 10 ml was immediately inoculated into blood culture bottle at bedside and sent for bacterial culture along with the remaining 10 ml for routine biochemical and cytological examination. Out of 50 patients, 28 (56%) were diagnosed to have spontaneous bacterial peritonitis or its variants. Classic spontaneous bacterial peritonitis was present in 11 patients (39.28%), 16 (57.14%) patients were found to have culture negative neutrocytic ascites and one patient (3.57%) had bacterascites. Out of 28 cases of spontaneous bacterial peritonitis 12 samples of ascitic fluid showed positive culture reports. E. coli was the most frequently cultured organism isolated in 8 (66.66%) cases, Streptococcus pneumonae in 2 patients (16.66%), S taphylococcus aurus and Klebsiella each in 1 case (8.33%). Spontaneous bacterial peritonitis and its variants is a common complication of liver cirrhosis with ascites. E. coli is the most frequent offending organism in these cases. Knowledge of the microbial spectrum of spontaneous bacterial peritonitis in a particular population is important for the selection of the most appropriate empiric antibiotic regimen.

Shamshad,Khyber Girls Medical College
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2010

Puerperal sepsis is one of the leading causes of preventable maternal morbidity and mortality. It is still ranked as 3rd major cause of maternal deaths in our country. The objective of this study was to evaluate morbidity and mortality from puerperal sepsis and to identify its risk factors. This observational study was carried out in Ayub Teaching Hospital over a period of three years. All patients admitted with diagnosis of puerperal sepsis secondary to genital tract infection were evaluated with thorough details of history and examination to determine their demographic details, obstetrical profiles, presenting features, state of infectious morbidity, need for intervention and mortality related to puerperal sepsis. Puerperal sepsis was 1.7% of all obstetrical admissions and 34.4% of postnatal complications. It was seen common among young patients of 15-25 years age. 61 (66.3%), of lower parity, 58 (63.00%), low socioeconomic status, 60 (65.20%), uneducated patients, 72 (78.20%), home deliveries, 68 (73.90%), prolong labour, 54 (58.60), prolong rupture of membranes from 48-72 hours, 68 (73.8%) and deliveries conducted by untrained birth attendants, 57 (60.5%). Puerperal sepsis morbidity was mostly foul smelling discharge, 23 (25%), retained product of conception, 41 (44.5%), peritonitis, 8 (8.60%), septicaemia, 4 (4.3%), pelvic abscess, 10 (10.80%), endotoxic shock, 4 (4.30%), disseminated intravascular coagulation, 2 (2.1%). Sepsis related mortality was 6/42 (14.2%). Puerperal sepsis is an important public health problem contributing to maternal morbidity and mortality. Majority of predisposing factors are preventable. Optimal antiseptic measures and careful monitoring are needed throughout the process of labour.

Parvez A.,Khyber Girls Medical College
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2010

Diabetes mellitus (DM) is a metabolic disorder characterised by chronic hyperglycaemia with disturbances in carbohydrate, fat and protein metabolism arising from defect in insulin secretion or action or both. The clinical guidelines recommend measurement of BMI as "vital signs" for evaluating the obese and diabetic patients. This study was carried out on 160 diabetics, which were divided on the basis of BMI into obese (120) and non-obese (40) diabetics from Peshawar district. All patients had their triglycerides and glucose checked after over night fast. The serum triglyceride in diabetics having BMI >30 (obese) was increased as compared to patients having BMI <30 (non-obese). The comparison of serum glucose level in obese diabetics was found to be significantly raised as compared to non-obese diabetics. It was concluded that dyslipidemia is common in all diabetics. The abnormal triglyceride level can improve with good glycaemic control, but do not reach the normal state. Good glycaemic control, Reducing BMI, periodic checkups of lipids and blood glucose are recommended for all diabetics in order to avoid complications.

Shah N.,Khyber Girls Medical College | Siddiqui S.,Aga Khan University
Pakistan Journal of Medical Sciences | Year: 2015

Smoking remains a major player in morbidity and mortality worldwide. It is a matter of immense public health importance as single leading cause of preventable deaths. The aim of this study was to assess smoking practices that prevail across Pakistan & Attitude of people towards this issue. We conducted an extensive search on major databases as well as search of bibliography of published literature for studies assessing Attitudes and Practices of tobacco smoking that prevail across Pakistan. Data from available studies was abstracted and utilized in preparation of this manuscript. After screening of 613 articles, we were able to identify 22 studies matching our criteria for inclusion. Majority of studies reported adolescence as time of initiation. Average national prevalence was 21.6%. A significant portion of smokers comprised of females. The prevalence of smoking in healthcare professionals ranged from 32 – 37%. Passive smoking was a major contributor of tobacco exposure. Prevalence of ‘Shisha’ use was 33%. Smoking continues to be a major Public Health issue in Pakistan. The prevalence in healthcare professionals and adolescents is alarming. Adequate measures need to be taken to ensure its control. © 2015, Pak J Med Sci. All rights reserved.

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