Endoscopic Third Ventriculostomy: A Comparable Alternative to Ventriculoperitoneal Shunt for Obstructive Hydrocephalus Secondary to Infratentorial Tumors

Objective: To establish ETV  as a comparable alternative to ventriculoperitoneal shunt for obstructive hydrocephalus secondary to infratentorial tumors. Methods: 40 Patients with infratentorial tumors presenting with hydrocephalus were enrolled in a prospective descriptive case series. Symptoms, neurological examinations, CT scan and intra-operative findings were used detect the complications at 03 months. Results:   Mean age = 31.98 ± 15.24 years, female to male ratio of 1:1.2. The KPS score of the participants was ? 70% and ETVSS ?80. Average operative mean time was 21 ± 2.82 minutes. Within first week, the improvement in symptoms was recorded (CI=95%): headache – 87.5% (p < 0.001), nausea vomiting - 84% (p < 0.001), gait disturbance – 59.3% (p=0.442) seizures improvement -100% (p=0.016) and urinary incontinence – 66.7% (p=0.687). Radiological improvement in hydrocephalus on CT scan was seen in one patient within 24 hours – 2.5% (p= <0.001), 12.5% (p<0.001) after two weeks and 87.5% (p= <0.001) after three months post-operatively (CI 95%). Most common of these were decrease in the size of third ventricle and decrease in the size of frontal horns of lateral ventricles.  However, complete resolution of radiologic features was observed in two patients only 5% (p<0.001). However, complete resolution of radiologic features was not observed in any patient. No intra-operative or post-operative complication of ETV was recorded. Conclusion: ETV is a quick and safe method for CSF diversion in obstructive hydrocephalus alleviating the need for placement of VP shunt hardware, thus eliminating foreign body related cranio-abdominal complications

Sensitivity of ciprofloxacin and ceftriaxone in children with urinary tract infections

Background: Urinary tract infections (UTIs) are the 2nd commonest bacterial infections, after respiratory tract infections (RTIs), and may go on to progress into chronic kidney disease among paediatric population. The objective of this study was to determine frequency of sensitivity of ciprofloxacin and ceftriaxone in children with urinary tract infections (UTIs).Methods: This descriptive, cross-sectional study was done at the department of pediatric medicine, Nishtar Hospital, Multan, from 10th August 2019 to 9th January 2020. A total of 165 patients presenting with UTI and aged 2 to 12 years of either gender were included. Urine sample was taken in sterilized container and sent immediately for urine culture and sensitivity tests.Results: In a total of 165 cases, mean age was 5.15±2.50 years while most cases, 113 (68.48%) were between 2 to 6 years of age. Out of the 165 patients, 112 (67.87%) were female representing female to male ratio of 2.1:1. Sensitivity of ciprofloxacin in 53 (32.12%) and ceftriaxone in 107 (64.85%) patients was found.Conclusions: This study showed the sensitivity of ciprofloxacin in 32.12% and ceftriaxone in 64.9% children with UTIs

Clino-pathological features of urinary tract infection: a study at Nishtar University Hospital Multan, Punjab, Pakistan

Background: Urinary tract infection (UTI) is a common clinical issue among pediatric population and might progress into renal scaring, hypertension as well as end stage kidney disease. This study was aimed at finding clino-pathological features of UTI and antibiotic sensitivity against most common causative agents involved at a tertiary care hospital of South Punjab, Pakistan.Methods: This descriptive case series study was conducted at department of Paediatric Medicine, Nishtar University Hospital Multan from July to December 2019. A total of 100 children fulfilling the inclusion criteria, presenting in outpatient department or emergency section of paediatric medicine department, having positive urine culture and sensitivity were selected. Their detailed history, clinical examination and relevant investigations were done.Results: Out of the 100 children, 73 (73.0%) were female and 27 (27.0%) were male. There were 57 (57.0%) children from 1 year to 4 years age group and 43 (43.0%) were of more than 4 years. Most common clinical presentations were fever 83 (83.0%), urinary symptoms, vomiting 52 (52.0%) and pain abdomen 48 (48.0%). Most common aetiological agents were Escherichia coli 74 (74.0%) and Klebsiella pneumoniae 9 (9.0%).Conclusions: UTI is more common in female children. Most common presentation observed was fever and/or urinary symptoms while most common aetiological agent was E. coli

Recurrent Occipital Dermatofibrosarcoma Protuberans: Multidisciplinary Management of a Rare Case

Dermatofibrosarcoma protuberance is a skin tumor arising from dermis, slow growing in nature and locally invasive. Most commonly present on extremities and rarely on head and neck region. We are presenting a case of 24 years old male with huge recurrent DFSP lesion in occipital region. We did wide local excision with tumor free skin margins of 2.5cm followed by excision of involved occipital bone and wound coverage with carotid artery flap. DFSP is challenging skin tumor with high recurrence rate and should be managed by multidisciplinary approach

Knowledge and Perception Among Gynecologists Regarding Screening of Domestic Violence against Women

Background and Objective: Domestic violence (DV) has been identified as a very serious problem that affects women and children atall levels of society, regardless of race, financial status, religion, and level of education. DV in Pakistan is a very sensitive issue keeping inmind the psychological, religious, and social aspects. The aim of the study was to assess the level of knowledge and perception about DVamongst gynecologists working in the tertiary care teaching hospitals of Lahore city, Pakistan.Methods: It was a cross-sectional survey study carried out among the doctors working in the Gynecology departments in different tertiarycare teaching hospitals of Lahore from July to August, 2021. A total of 154 doctors of the Gynecology departments participated in this study.Results: Most of the participants (53.4%) had suboptimal knowledge regarding the screening tools for DV against the women reporting inGynecology clinics from July to August, 2021. A significant association was found between awareness regarding DV and an agreement forintroducing a formal training course (p &lt; 0.05).Conclusion: The knowledge and perception of health care providers to screen the cases of DV is the basic key to identify such victims.However, a proper training of the staff handling such patients needs to be implemented at government level.</p

Rectal diclofenac; an effective modality for pain relief after vaginal birth

Background and Objective: Vaginal delivery (VD) is the safest delivery option for the mother and is associated with quick recovery and minimal maternal morbidity and mortality. However, one of the commonest fears among women about VD is pain. This study aims to assess the effectiveness of diclofenac suppositories (per rectum) compared to the intramuscular diclofenac for the pain relief in females after VD.Methods: This prospective comparative was study conducted at the Emergency Section (labor room) of Obstetrics &amp; Gynecology Department in one of the tertiary care teaching hospitals of Lahore, Pakistan. A total of 182 female patients undergoing VD were selected and further divided into group A and group B. Group A was administered rectal analgesia in the form of rectal suppositories (100 mg) immediately after perineal tear (first and second degree only) repair and repeated after 6 hours. While group B received one injection of intramuscular diclofenac, immediately after perineal tear repair. The pain score was measured on a graphical score using Graphic Rating Scale, immediately at rest, during movement, and during urination. The pain score was reassessed after 6 hours with the same parameters and compared between both groups.Results: The overall pain score was significantly lower immediately (p = 0.004) and 6 hours (p = 0.002) after VD in group A at rest, during movement, and during urination as compared to group B.Conclusion: The use of rectal diclofenac suppositories is a simpler and more effective and acceptable method of reducing the pain experienced by the women following perineal trauma after vaginal childbirth.</p

Correction: Malik et al. Integrated Tuberculosis and COVID-19 Activities in Karachi and Tuberculosis Case Notifications. <i>Trop. Med. Infect. Dis.</i> 2022, <i>7</i>, 12

The authors wish to revise the second citation of reference [26] to [27] in the original article main text [...