Physical Co-morbidity according to ICD-10 criteria among patients with depressive disorder

Objective: To detect the prevalence of physical co-morbidities according to International Classification of Diseases[ICD-10] among patients with Depressive disorder

Design: Descriptive cross sectional study

Setting: Psychiatric consultation clinic of JPMC Karachi

Methods: Patients of either gender and age >18 years were consecutively selected after informed consent, Ethical issues were addressed according to Institutional Review Board [IRB], JPMC, Karachi. Patients with psychotic symptoms, personality disorders, dementia, and history of substance use were excluded. ICD-10 criteria, beside complete history, physical examination and lab investigations were used to confirm the diagnosis of depression and physical co-morbid. Prescribed questionnaire was used to collect the data and analyzed in SPSS version-17. Descriptive statistics were calculated for age, gender, marital status, education, socioeconomic status and co-morbidity

Results: Total 100 cases fulfilled the inclusion criteria. Their Mean +/-SD age was 32.7 +/-16.7 years. Both genders were equally vulnerable, [50% each]. Fifty three percent had moderate, 31% mild and 16% had severe depressive disorder. Hypertension was the most common [18%] in male patients and sinusitis was the most common [28%] in female patients with depression. Other co-morbidities included Diabetes Mellitus, Epilepsy, Migraine, HCV, Anemia, Chronic Kidney Disease [CKD], Urinary Tract Infection [UTI] and Menopausal syndrome [in women], Obesity, Asthma and Facial pain

Conclusion: Physical co-morbidities are prevalent among patients with depressive disorder. Presence of physical co-morbid may decreases the chances of treatment compliance, increases risk of treatment failure, relapse of depression, worse prognosis and elevated the treatment cost. Early detection and simultaneous management of these co-morbid with depression are suggested

Prospects for the sustainability of delivering the basic package of health services in Afghanistan: a stakeholder analysis

This study explored the readiness of stakeholders in Afghanistan for sustaining delivery of the Basic Package of Health Services [BPHS] without external technical and financial assistance. A stakeholder analysis was applied using qualitative methods. Fifteen stakeholders were purposively drawn from the Afghanistan ministries of public health and finance, political representatives, development partners, nonprofit organizations and public health experts. Data were collected through in-depth interviews with the stakeholders and desk review of pertinent documents. We found that sustainability of the BPHS in Afghanistan is questionable as stakeholders are suboptimally organized to come up with effective alternatives. Uneven ownership and divisive positioning are bottlenecks to the evolution of a realistic continuation plan. Those with the most significant influence are lukewarm, while those who are most supportive have the least influence. Sustainability needs to be tackled at the start in designing the BPHS rather than in the wake of eventual donor withdrawal

Sputum neutrophilia in severe persistent asthmatics

Objective: To determine the frequency of sputum neutrophilia in patients with severe persistent bronchial asthma. Study Design: A cross-sectional study. Place and Duration of Study: Department of Medicine, Military Hospital, Rawalpindi, from November 2009 to November 2010

Methodology: Cases of severe persistent bronchial asthma, aged between 12 and 40 years, were included. Sputum samples were collected by induction with hypertonic saline [4.5%]. All samples were centrifuged and differential neutrophil count was calculated. Data was analyzed using SPSS 11

Results: Out of 195 patients, there were 129 [66.2%] males and 66 [33.8%] females. The mean age was 27.01 +/- 6.92 years. Mean sputum neutrophilic count was 126.47 +/- 16.52 x 106/ml and the mean neutrophilic percentage was 63.187 +/- 8.3363. Sputum neutrophilia was present in 84 patients [43.1%], out of whom, 56 were males and 28 females. In patients with sputum neutrophilia, mean neutrophilic count was 142.40 +/- 8.49 x 106/ml and the mean neutrophilic percentage was 71.2024 +/- 4.2441%

Conclusion: Sputum neutrophilia is a frequent finding in cases with severe persistent bronchial asthma. Presence of sputum neutrophilia in such cases can lessen the inappropriate use of corticosteroids with their associated long-term side effects

Maternal deaths in induced abortion

This paper is based on two studies earned out 12 years apart in a large teaching hospital. It covers 81 induced abortions admitted during a period of 2 years and 9 months; these formed 2.34% of a total of 3462 abortions admitted during both the study periods. Of the 81 women with induced abortions, 21 [25,93%] were admitted with visceral injury [mainly uterine perforation with or without bowel injury], 34 [41.98%] with haemorrhage, and 23 [28.39%] with sepsis. Thirteen [16.05%] women died; 8 as a result of visceral injury and 5 due sepsis. These deaths formed 12.62% of the total 103 maternal deaths which occurred during the two periods under study

Effect of clofibrate on lipid levels in various tissues of uromastix hardwiskii

Effect of clofibrate on the levels of cholesterol, phospholipids and esterified glycerides in heart, liver, adipose tissue and blood of Uromastix hardwickii was studied. 5 mg clofibrate was injected i.p. and above parameters were estimated using ethanol treated animals as controls. Lipid levels in all these tissues were found to be decreased within one hour and continued to decrease up to six hours. However, in most cases after 24 hours an insignificant increase was observed

Scoring of surgical sepsis in head and neck surgery

Sepsis in surgery is a scourge that a surgeon simply must avoid. However despite his utmost effort, sometimes one is confronted with a situation of infection following surgery which may mar his entire endeavour. Just like pain, infection is an abstract clinical entity; the difference being that while pain is a subjective phenomenon, infection is an objective state. In order to aptly describe the clinical status of sepsis, and to be able to compare or reproduce one's findings in ideal situation in different patients, an index for sepsis is needed. Such a unit of measurement is called 'scoring' Such vague terms as mild moderate or severe should be discarded. Several forms of 'scoring in sepsis' have been in vague in different centers of the world. They are reviewed in this article, and a modification of 'Elabute and Stoner's system of scoring, applied in our department is presented

Incidence of Hepatitis-B in hospital admitted cases of Hepatitis

All patients with jaundice admitted in Medical;D; Unit Hayat Shaheed Teaching Hospital were investigated throughly. Two hundred and twenty were diagnosed as suffering from hepatitis. Hundred and eleven out of these two hundred and twenty were positive for Australia, Surface Antigen [50.0%] Mortality rate was 11.8% in all the cases

Biochemical alterations in the levels of DNA, RNA and protein in discrete areas of rat brain following nuvacron toxicity

The levels of DNA, RNA and Protein were estimated in cerebral hemisphere, cerebellum and brain stem of male albino rats with Nuvacron [0, 0, dimethyl - 0 -1 methyl 3 - methylamino - 3 - oxe -1 - propenyl phosphate] 4 mg/kg body weight intraperitoneally [i.p.] daily for 10 days. The daily i.p. dose of Nuvacron depleted the level of DNA and protein in all brain regions. Increased level of RNA was observed in cerebral hemisphere, cerebellum and brain stem