The Efficacy of Spirometry as a Screening Tool in Detection of Air Flow Obstruction

Background/Objectives: In developing countries, spirometry has not been considered a part of routine medical check-up. The purpose of the study was to establish the usefulness of spirometry as a primary screening tool in detecting air flow obstruction (AFO) during routine medical check-up (RMC). Methods: This was a hospital based, retrospective, non-randomized case series study of 3696 participants, who presented to hospital for routine medical check-up. All subjects were assisted at the Pulmonary Medicine Department, from January 2003 till December 2008 who, having met other inclusion criteria, underwent spirometry. Data were analyzed using proportion, group means, standard deviations and Pearson Chi Square test. Results: The overall yield from spirometry in detecting AFO was 211 patients (5.7%); 174 males (6.1%) and 37 females (4.4%) (P=0.158, Pearson Chi Square test). Greater age at presentation and BMI correlated significantly with AFO in the target group (P=\u3c0.001; P=\u3c0.005) respectively. Dyspnoea was the most frequent symptomatology observed in those diagnosed with AFO. Conclusion: These results suggest that spirometry during RMC for all persons can detect a significant number of patients with AFO particularly among the middle and older age groups with a low BMI

To determine the level of satisfaction among medical students of a public sector medical university regarding their academic activities

<p>Abstract</p> <p>Background</p> <p>An ongoing evaluation system is essential to determine if the academic system in place has worked to produce a better product, hence the objective of our study was to evaluate the satisfaction level among medical students regarding their academic teaching and assessment method and what measures will they suggest for the future to rectify the current situation.</p> <p>This questionnaire based cross sectional study was conducted in a public sector medical university from February to July 2010. A well structured questionnaire was administered to a random sample of 375 final year medical students. However 292 of the students provided informed consent and filled in the questionnaire which included their demographic profile as well as questions in line with the study objective. Data was entered in a Statistical Package for Social Sciences (SPSS version.16) and analyzed using descriptive statistics.</p> <p>Findings</p> <p>The male to female ratio in our study was 1:2. Most of the students (57.2%) were dissatisfied with the quality of teaching in the university. Fifty-seven percent of the participants believed that the current standard of their institute were not at par with those of international medical universities. BCQ's were the mode of examination questions preferred by the majority of the students. Most of the students (66.1%) wanted the university to conduct career planning seminars to help them plan their career.</p> <p>Conclusions</p> <p>These results suggest that the students of public sector medical universities are unsatisfied from current academic facilities and teaching activities. Students recommend increased emphasis on better lectures and practical training as well as a need to incorporate career planning sessions for the students to help plan them their future career paths.</p

The study of etiological and demographic characteristics of acute household accidental poisoning in children - a consecutive case series study from Pakistan

Abstract Background To determine the agents of poisoning and demographic distribution of children brought to Civil Hospital Karachi (CHK) with a history of accidental poison intake and to examine the factors associated with it. Methods This hospital based descriptive study of first 100 patients from both sexes who presented to Pediatric department, CHK from 1st January 2006 till 31st December 2008 with exposure to a known poisonous agent and fulfilling other inclusion criteria were included in the study. Data regarding their demographic profile and potential risk factors was collected on a well structured proforma, cases were followed until discharge or expiry. Data was analyzed using frequencies, proportions, group means, median and standard deviations. Results The male to female ratio in our study was 1.2:1, with kerosene (50%) being the most common household agent followed by medicines (38%), insecticides (7%) and bathroom cleaners (5%). Factors such as mother's education level, number of siblings and storage place of poison correlated significantly with the cases of accidental poisoning. Most of the children (70%) presented within 3 hours of ingestion. Dyspnea was the most common symptom observed. The mortality rate in our study was 3%. Conclusions Children belonging to age group 2-3 years are the most susceptible both in terms of morbidity and mortality. Preventive strategies need to be adopted at a national level to spread awareness among parents.</p

The Study of Etiologic and Demographic Characteristics of Intracranial Brain Abscess: A Consecutive Case Series Study from Pakistan

Background:To determine the demographics, management, bacteriological spectrum, and outcome of brain abscesses of Patients brought to Aga Khan University Hospital (AKUH), Karachi, with a history of neurologic symptoms and to examine the factors associated with it. Methods: This hospital-based descriptive study included 53 Patients from both sexes who presented to the neurosurgery section at AKUH from January 1, 2000, until December 31, 2008, with neurologic symptomatology and fulfilling other inclusion criteria. Data regarding their demographic profile and other factors were collected in a well-structured proforma. Data were analyzed using frequencies, proportions, group means, and standard deviations. Results: The male-to-female ratio in our study was 3.4:1, with Staphylococcus milleri (20.7%) being the most common etiologic agent followed by anaerobic bacteria (15.1%). The triad of headache, fever, and vomiting was present in 62.7% of Patients at the time of presentation. The most important factors influencing mortality was the neurologic condition of the Patient at the time of admission. Chronic suppurative otitis media was the most common predisposing factor for temporal lobe infections, and the frontal lobe was the most common site of involvement in majority of the Patients (67.8%). The mortality rate in our study was 11.3%. Conclusions: Findings suggest that Patients in the second and fourth decades of life are the most susceptible, both in terms of morbidity and mortality. Early diagnosis and appropriate management, along with rapid access to tertiary care centers, will lead to a better prognosis

Effect of intraoperative use of topical mitomycin C on intraocular pressure in patients with pterygium excision

Abstract Aim: To determine the effect of intraoperative adjunctive topical mitomycin C on intraocular pressure in patients undergoing pterygium excision.Methods: This was a descriptive interventional case series of 102 patients (118 eyes) with different grades of pterygium treated from 1995 to 2008. All patients underwent pterygium excision with intraoperative mitomycin C 0.2 mg/mL administered for 1 to 5 minutes. Changes in intraocular pressure were recorded on days 1 and 7, and at 3 months. Data were analysed using proportion, group means, standard deviations, analysis of variance, and paired Student t test.Results: There was no significant decline in intraocular pressure throughout the follow-up period (p = 0.435, Student t test). At 3 months postoperatively, 109 eyes (92.4%) had no changes in intraocular pressure \u3e5 mm Hg, of whom 78 (72%) experienced minimal changes that were not statistically significant.Conclusions: Intraoperative topical administration of mitomycin C has a minimal effect on lowering intraocular pressure in patients with pterygium. These results do not support the trans-scleral effect of mitomycin C on the ciliary body as an intraocular pressure–lowering mechanism in glaucoma filtering surgery