Serological monitoring of HCV marker in hemodialysis patients from tertiary care hospitals of Karachi

This study was conducted to estimate the seroprevalence of HCV in maintenance hemodialysis patients. Experimental prospective study. This study had been camed out in the Department of Microbiology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi from 1[st] July, 2010 to 30[th] April, 2011. Irrespective of age and gender 200 samples were collected from the patients on chronic maintenance hemodialysis that at least had 20 cycles of hemodialysis from tertiary care hospital of Karachi. The nature of the sample was 5 cc blood. All the study subjects were briefed about the study program and a written consent form had been signed after getting permission from hospital ethical committee. Diagnosed patients of HCV prior to commencement of hemodialysis and patients who had less than 20 hemodialysis cycles were excluded from this study. Two hundred patients [125 male and 75 females] were between the ages of 30-77 years with mean 56.7 +/- 0.68. 29% patients were seropositive for HCV in chronic maintenance hemodialysis patients. According to duration of dialysis, 3.5% were seropositive in whom duration of dialysis was less than 1 year, 18.4% were seropositive in whom duration of dialysis is in between 1.1-2.0 years, 13.3% were seropositive in whom duration of dialysis is in between 2.1-3.0 years, 52.6% were seropositive in whom duration of dialysis is in between 3.1-4.0 years while 61% were seropositive in whom duration of dialysis is more than 4 years. Highly significant statistical difference is observed as the duration of dialysis increases as p-value is highly significant as 0.001 for HCV. Seroprevalence of HCV infection according to schedule of dialysis is insignificant as the p-value is greater then 0.05. This study confirms that HCV infection is a serious and major problem in our hemodialysis units. Duration of dialysis and surgery is directly proportional to the seropositivity, while transfusion was not statistically related to the cause of HCV infections in hemodialysis patients

Diagnostic value of fine needle aspiration cytology in the diagnosis of solitary thyroid nodule

Objectives: To determine the diagnostic value of fine needle aspiration cytology in the diagnosis of solid solitary thyroid nodules

Patients and Methods: This study was conducted at the department of Ear, Nose, Throat, Head and Neck surgery at Postgraduate Medical Institute Lady Reading Hospital Peshawar. This was cross-sectional comparative study. The duration of the study was one year from June 17, 2010 to June 16, 2011. The sample size was 82 patients with solid solitary thyroid nodule, fulfilling the inclusion criteria. Fine needle aspirations were performed in all cases and compared with open biopsies taking as gold standard

Results: Our study included 82 cases consisting of 57 [69.51%] female and 25 [30.48 %] male, with female: male ratio of 2.28: 1. The age of the patients was ranged from 16-65 years with mean age of 42.56 +/- S.D 11.60 years. Most of the patients presented in 3rd and 4th decade followed by the 5th and 2nd decade. The diagnostic yield of fine needle aspiration cytology [FNAC] in this study was accuracy 82.92%, sensitivity 88.09%, specificity 77.50% and positive predictive value was 80.43% that supported our hypothesis

Conclusion: FNAC is a primary diagnostic tool for solitary thyroid nodule because it is simple, safe, quick, reliable, minimally invasive, and cost effective

Old is gold. topical clotrimazole remains an effective treatment of otomycosis

Introduction: Otomycosis also known as fungal otitis externa has typically been described as fungal infection of the external auditory canal. The prevalence of otomycosis has been reported to be as low as 9% of cases of otitis externa and as high as 30.4% in patients presenting with symptoms of otitis or inflammatory conditions of the ear. The most common fungal agents causing otomycosis are aspergillus niger [80%], candida albicans [second most common], actinomyces, trichophyton, aspergillus fumigatus and candida tropicalis

Methods: It was descriptive case series of six months duration done at department of ENT, Islamabad Medical and Dental College Islamabad. Sample size was 119, using 50%8 efficacy of topical clotrimazole, 95% confidence level and 9% margin of error under WHO software for sample size determination

Results: A total of 119 patients of otomycosis were included in the study. Male to female ratio was 0.61:1. Average age of the patients was 32.94 years +/- 5.24 SD with range 20-40 years. The efficacy of clotrimazole in treatment of otomycosis was observed in 112 [94.12%] while in 7 [5.88%] patients show no efficacy. Age and gender have no role in efficacy of clotrimazol in treatment of otomycosis

Conclusion: Topical clotrimazole is effective in the treatment of otomycosis

Unusual oropharyngeal foreign body

We present an unusual case of foreign body [sewing needle] in a young man, who swallowed it with bolus of food. It penetrated through soft palate into parapharyngeal space, detected with image intensifier and removed successfully. Postoperative course remained uneventful

Pneumonia; frequency of under nutrition in children under 5 years of age

To find out an association between undernutrition and severity of pneumonia in children under five years of age. The study was carried out at paediatric department of Military Hospital Rawalpindi. From August 2003 to January 2004. Cross sectional analytical study. Children of either gender from 2 to 59 months of age with the clinical diagnosis of pneumonia made according to WHO guidelines were classified into various grades of nutritional status with referrence to the NCHS standards for weight for age. Five hundred children, including 280 [56%] boys and [220] 44% girls with the mean age 20.36 [ +/- 14.26] months were evaluated. One hundred and ninety five [39%] had pneumonia, 158 [31.6%] had severe pneumonia, whereas 147 [29.4%] had very severe pneumonia. Two hundred and eighty six [57.2%] children were normally nourished whereas 214 [42.8%] were undernourished; 133/214 [62.1%] had moderate and 81/214 [37.9%] had severe undernutrition. Fever [81%], cough [77%], nasal flaring [76%], tachypnoea and chest indrawing [61%] were the commonest presentations. The mean hospital stay was 6.9 [ +/- 2.65] days. Thirteen [2.6%] patients including 5 [38.5%] boys and 8 [61.5%] girls, who all were undernourished, expired. The relative risk of death in undernourished children was 1.065 times [95%CI= 1.029 to 1.102] that of normally nourished children [p<0.0001]. Younger age, severity of pneumonia and undernutrition are significant risk factors for morbidity, prolonged hospitalization and mortality in young children with pneumonia