Aerobic Bacterial Contamination In Platelet Concentrates At The Regional Blood Centre, Peshawar.

BACKGROUND: Platelet concentrates play a crucial role in transfusion medicine, aiding in the management of various medical conditions, including haemorrhage, thrombocytopenia, and platelet dysfunction. However, their storage conditions at 22° C present an optimal environment for bacterial growth, making them susceptible to contamination. Of particular concern is the transmission of microorganisms from the skin flora during the phlebotomy process, which can lead to the transfusion of contaminated platelet concentrates. Such contamination poses significant risks to patients, potentially resulting in morbidity and mortality. Determining the frequency and identifying causative organisms of bacterial contamination in platelet concentrates. METHODS: It was a descriptive cross-sectional study conducted at the Institute of Pathology and Diagnostic Medicine, Khyber Medical University, and the Regional Blood Center in Peshawar from May to October 2021, spanning a duration of six months. The study included 500 participants aged between 18 and 50 years (mean: 28.13±7.67 years. A simple convenient sampling technique was employed. Blood products underwent screening for Hepatitis B, Hepatitis C, HIV, Syphilis, and Malaria. Leaked units were excluded from the study. Platelets were prepared using a Cryofuge and subsequently subjected to culture media. RESULTS: The mean age of the participants included in the study was 28.13±7.67 years, with an age range of 18 to 50 years. Out of the total sample size of 500, there were 483 (96.6%) male participants and 17 (3.4%) female participants. Among the collected samples, bacterial growth was observed in only 11 (2.2%) platelet concentrates. The isolated organisms were Staphylococcus epidermidis, found in 7 (1.4%) platelet concentrates, and Staphylococcus aureus, found in 4 (0.8%) platelet concentrates. CONCLUSIONS: Bacterial contamination of platelet bags is higher compared to developed countries. Therefore, implementing quality control procedures is necessary to reduce the risk of bacterial contamination in platelet concentrates. Additionally, employing enhanced skin disinfection techniques at the phlebotomy site can significantly minimize bacterial contamination.

Comparison Of Efficacy Of 10% Potassium Hydroxide Solution Versus Cryotherapy In Treatment Of Molluscum Contagiosum.

BACKGROUND:: Different topical therapies are being used for treating molluscum contagiosum. Potassium hydroxide in varying solution strengths with irritant reaction on the skin can help in eliminating the infection. It is cheap, easily available, can be easily applied at home, with good safety profile and cost effectiveness. This study was conducted to compare the efficacy of 10% potassium hydroxide solution versus cryotherapy in treating molluscum contagiosum. METHODOLOGY: This study was a Randomized control trial conducted in the Department of dermatology, Military hospital Rawalpindi. Study included 120 randomly selected patients with molluscum contagiosum divided equally into two groups. Group A were treated with 10% potassium hydroxide aqueous solution applied daily to the lesions twice daily for 6 weeks while Group B received weekly cryotherapy with liquid nitrogen. The status of lesions was documented weekly for 6 weeks. RESULTS: Of the 120 patients enrolled, 67 (55.8%) were male and 53 (44.2%) were female. Mean age of patients was 20.53(±8.17) years. At base line Molluscum contagiosum lesion ranged from minimum of 2 lesions to maximum of 26 lesions with a mean of 8.95 (SD ±4.45) lesions. Of 120 patients, complete clearance was observed in 98(81.6%) of patients, 48(80%) patients had lesion clearance in Group A and 50 (83.3%) patients had lesion clearance was observed in Group B. No statistical significance was observed in the lesion clearance between the two groups (p-0.63). CONCLUSIONS: The efficacy of 10% potassium hydroxide solution and cryotherapy is statistically same over 6 weeks of treatment. Thus less expensive, easily available and cosmetically more acceptable potassium hydroxide solution can be used instead of cryotherapy in treating molluscum contagiosum.

Frequency of diabetes mellitus in patients with acute coronary syndrome.

BACKGROUND: Diabetes mellitus is a major risk factor for atherosclerosis which eventually causes cardiovascular disease specially affecting coronary arteries. Patients with diabetes have a risk for coronary events similar to that of patients without diabetes who have already had an event, and conversely many patients with established coronary artery disease suffer from diabetes or its pre- states. The objective of study was to determine the frequency of diabetes mellitus in patients presenting with acute coronary syndrome in our setup. METHODS: This cross sectional study was conducted in the Department of Cardiology and Medical unit-B of Ayub Medical College, Abbottabad from October 22, 2009 to April 22, 2010. All patients of either gender presenting with acute coronary syndrome above 25 years of age were included in the study by consecutive non- probability sampling. RESULTS: Two hundred and fifty patients were included in study. Of these 161 (64.4%) were males and 89 (34.6%) were females. The mean age of the study participants was 57.75 years. Frequency of diabetes mellitus was 3 1.6% and most (62%) of the known diabetics with ACS were having poor glycaemic control. The coronary event which was seen in the majority (74%) of patients was ST segment elevation myocardial infarction. CONCLUSION: The frequency of diabetes mellitus in this study was significant as one out of every third patient with acute coronary syndrome was diabetic.

Frequency of albuminuria in diabetic patients presenting with macrovascular complications.

BACKGROUND: Diabetes mellitus is major cause of morbidity and premature mortality from its long-term complications such as cardiovascular disease, blindness, renal failure, amputation and stroke. The study was conducted to determine the frequency of albuminuria in diabetic patients presenting with macro-vascular complications like myocardial infarction (MI) and stroke. METHODS: This descriptive study was conducted at Ayub Medical College, Abbottabad from December 2010 to May 2011. Total 88 diabetic patients admitted with macro-vascular disease were included in this study. The patients were subjected to two urine specimen's examination, one for routine examination for infection and dipstick analysis for albuminuria. Second was tested for albumin was tested in the urine. RESULTS: Out of 88 patients with a mean 47.12 ± 7.58 years, 39 (44.32%) were female while 49 (55.68%) were male. Overall albuminuria was detected in the urine of 81 out of total 88 patients (92%) when tested by heating method whereas it was detected in 41 (46.6%) cases by the dipstick method. CONCLUSION: Frequency of albuminuria is much.higher in diabetic population with macro-vascular complications; hence albumin in the urine of diabetic patient can be regarded as an indicator for impending macro-vascular complications of diabetes.

Common risk factors for the development of anti tuberculosis treatment induced hepatotoxicity.

BACKGROUND: Tuberculosis is a global pandemic which affects millions of people every year. The treatment of tuberculosis consists of simultaneous use of a number of drugs for a prolonged period of time, therefore anti-tuberculosis treatment induced toxicity is a real problem. Many risk factors which make a tuberculosis patient prone to the development of hepatotoxicity associated with the anti-tuberculosis treatment have been identified. The aim of this study was to determine common risk factors responsible for precipitation of hepatotoxicity following treatment with anti-tuberculosis drugs. METHODS: This cross-sectional study was conducted in the Department of Pulmonary Medicine, Ayub Teaching Hospital, Abbottabad from 20th April 2013 to 19th March 2014. Patients -' , who were newly diagnosed cases of tuberculosis in whom treatment of tuberculosis with first line anti-tuberculosis drugs was initiated and were 20 years or older, were included. The precipitation of drug induced hepatotoxicity was diagnosed with detailed history taking and physical examination followed by laboratory investigations, i.e., Liver Function tests (LFT). RESULTS: Of the total 179 patients included in this study, 100 (55.8 %) were males and 79 (44.2 %) were females. Out of them 23 (12.85%) developed hepatotoxicity. Drug induced hepatotoxicity was observed in the older patients. No relationship was found with the sex, body mass index (BMI), and pre-existing liver disease. CONCLUSION: The study showed that the risk of development of drug-induced hepatotoxicity following treatment with first line anti-tuberculosis treatment increased with the age of the patient.

Spectrum of trigeminal neuralgia.

BACKGROUND: Trigeminal neuralgia (TN) is a very painful condition characterized by paroxysmal shock like pain in the distribution of one or more branches of trigeminal nerve caused by neurovascular conflict at the root entry zone of trigeminal nerve. This study was conducted to analyse the demography and pattern of TN in our setup. METHODS: This descriptive study was conducted in the Oral Surgery unit, Department of Dentistry, Ayub Medical College. Abbottabad, from April 2009 to October 2011. A total of 117 patients were included in study by convenience (non probability) sampling technique. All the patients presenting with the clinical features of TN were included in study. RESULTS: Out of 117 cases, 49 (41.9%) were males and remaining 68 (58.1%) were females. Age of the patients ranged from 32-72 (53.90 +/- 10.21) years. Right side was involved in 63 patients (53.8%), while the left side was involved in 51 patients (43.60). In only three cases (2%) there was bilateral involvement. The maxillary division was involved in 68 cases (58.1%) and mandibular division was involved in 37 cases (31.6%). The most common site of involvement was infra-orbital, which was involved in 68 cases (58.11%). The next common site was the mental nerve which showed involvement in 35 cases (29.9%) followed by inferior alveolar nerve which was affected in 14 cases (12%). Thirty three (28.2%) patients were having mild pain. 54 (46.2%) patients having moderate, 21 (18%) patients with severe and 9 (7.7%) patients were having very severe pain. No patient in our study had a family history of TN. Among our patients 103 (88%) patients underwent dental extraction for the same pain. CONCLUSION: The incidence of TN is more in old age especially in females. TN is frequently misdiagnosed in with tooth ache, so there is need to educate the medical practitioners and masses in order to avoid un-necessary tooth extractions.

Frequency of seropositivity of Helicobacter pylori in patients presenting with dyspepsia.

BACKGROUND: Dyspepsia is a common health problem and most of the causes of dyspepsia are related to infection by Helicobacter pylori (H. pylori). Prevalence of H. pylori infection is different in different parts of the world. Purpose of our study was to determine the frequency of H. pylori infection in patients with dyspepsia in our setting where the prevalence of H. pylori was expected to be high. Objective of this study was to determine the frequency of H. pylori seropositivity in patients with dyspepsia. METHODS: A Cross sectional, descriptive study was conducted at the Department of Medicine, Ayub Medical College, Abbottabad from March to September 2009. Patients presenting in Medical outpatient departments of Ayub Teaching Hospital, Abbottabad with dyspepsia were included in the study and interviewed according to Reflux Disease Questionnaire and their serum sent for estimation of anti H. pylori IgG antibodies by enzyme linked immunosorbent assay (ELISA). RESULTS: A total of 92 patients were included in this study. Out of these 31 (33.7%) were males and 61 (66.3%) were females. Out of them 68 (73.9%) were found seropositive for H. pylori by ELISA. CONCLUSION: H. pylori infection is frequent in patients with dyspepsia in our setting and apparently uncomplicated dyspepsia should always be tested for H. pylori and all seropositive patients should be offered eradication therapy.

TB dots strategy in District Rawalpindi: results and lessons.

BACKGROUND: Tuberculosis (TB) is one of the most ancient diseases of mankind. Despite newer modalities for diagnosis and treatment, unfortunately, people are still suffering, and TB is among the top 10 killer infectious diseases in the world. TB is a devastating disease due to its rapid transmission and high rate of mortality causing around 1.8 million deaths annually. This study was conducted to evaluate the effectiveness of the Directly Observed Therapy Short-course (DOTS) in the target population. METHODS: Two Tehsils of District Rawalpindi were selected for the study. All patients under TB treatment attending Basic Health Units (BHUs) and Rural Health Centres (RHCs) were included in the study. The patients with extra pulmonary TB and children under five years of age were excluded from the study. All patients were contacted individually and asked about the DOTS program activity using a preformed questionnaire that mainly contained questions regarding knowledge of the patients about their disease and the role of health facility in treating and following the disease. RESULTS: Out of the 224 patients who were included in the study, 87 (38.8%) were male, and 137 (61.2%) were female. Majority (48.8%) of the patients was in age group of 21-40 years and 62.5% patients had positive family history of TB. Among the patients, 51.8% were illiterate, 31.7% had studied till primary level, and only 16.5% had the educational qualification of Matric or above. In our study 69.2% of patients themselves or through their relatives reported to the health facilities to get treatment, while the rest were picked by community health workers, 62.9% were diagnosed by the public hospitals, 23.2% were diagnosed by general practitioners and 12.9% by the federal public hospitals. In our study 69.6% of the patients were not observed at all or were observed by the family members. CONCLUSION: TB is mainly a disease of the poor and illiterate people. Despite many achievements a bulk of patients are not picked by the community health providers nor are they properly observed. We need to improve the current working of the DOTS personnel. General practitioners are playing a big role in diagnosing the disease, so they need to be integrated in the DOTS to effectively diagnose and control TB.