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Showing papers by "Chandka Medical College published in 2004"


Journal Article
TL;DR: D diagnosis with CT scan, appropriate antibiotic therapy and complete removal of abscess along with excision of capsule could reduce the mortality and neurological deficits from brain abscess.
Abstract: Objective To evaluate the clinical presentation, diagnosis, sources of infection, surgical management outcome and microorganisms involved in the brain abscess in our locality. Design Descriptive study. Place and duration of study The department of Neurosurgery, Chandka Medical College Hospital, Larkana from July 1998 to June 2003. Subjects and methods All patients who were confirmed cases of brain abscess were entered into the study. Data collected on proforma, contained categories of age, gender, clinical presentation, diagnostic laboratory findings, computed tomography scan reports, associated anomalies, surgical management, culture reports antibiotic therapy, microbiologic features and treatment out come. Results Out of 82 patients, 58 were males and 24 females. Mean age was 18 years (range 05 months to 55 years). Headache with papilloedema was the commonest presentation (82%). Neurological deficit was present in 46%. A source of infection was present in 89%. Otogenic source was the commonest (63%). CT scan was diagnostic in all (100%) cases. Solitary abscess was found in 79% of the cases while in 21% of the cases multiple abscess were found. Temporal lobe was the commonest site involved (55%). Cultures were found positive for microorganism in 82% of the cases. Bacteriodes (38%) and Streptococci (25%) were the commonest isolates. Burr hole aspiration was done in only 38% of the cases while excision of the capsule along with aspiration was carried out in 62% of the cases. Over all morality was 22% in this series; causes of death were septicemia, ventriculitis and pneumonia. Conclusion Diagnosis with CT scan, appropriate antibiotic therapy and complete removal of abscess along with excision of capsule could reduce the mortality and neurological deficits from brain abscess.

32 citations


Journal Article
TL;DR: Anti-tuberculous therapy with pyrazinamide affects the uric acid levels early and this change is reversible after the withdrawal of the agent, according to this observational study.
Abstract: Objective To record the effect of pyrazinamide on uric acid in patients of tuberculosis. Design Descriptive and observational study. Place and duration of study Chandka Medical College Hospital, Larkana from February 2000 to January 2003. Patients and methods All patients receiving anti-tuberculosis drugs with pyrazinamide were included. Serum uric acid levels were monitored at weeks 0, 2, 8 and 12 of therapy. Serum creatinine was done at weeks 0, 8 and 12. Results Results were reported on 216 patients. Mean uric acid and creatinine levels at the start of therapy, i.e., week '0' were 5.07 -/+ 0.57 mg/dl and 0.87 -/+ 0.11 mg/dl respectively. The results show significant increase in uric acid levels from week '0' to week '2', at the end of week '8', the levels remained elevated and there was no statistical significant difference from that at week '2'. The uric acid levels reduced at week '12' after pyrazinamide was stopped and the difference was significant. Despite that renal function steadily improved with the treatment of tuberculosis to the extent that comparable pre-treatment values were obtained at the end of treatment. Conclusion Anti-tuberculous therapy with pyrazinamide affects the uric acid levels early. This change is reversible after the withdrawal of the agent.

24 citations


Journal ArticleDOI
01 Dec 2004-BMJ
TL;DR: What would you do if human bones were an essential part of your medical course but your university could not afford them?
Abstract: What would you do if human bones were an essential part of your medical course but your university could not afford them? Three medics from Pakistan present some ways out of the dilemma The practice of robbing graves to facilitate scientific study of bones and cadavers is nothing new in medicine. In the early 18th century, Britain witnessed a booming trade of exhumed human bodies controlled by grave robbers when anatomy and dissection of the human body became an integral part in study of modern medicine. Because exhuming bodies was considered to be a sacrilege, grave diggers--also known as body snatchers, resurrectionists, or sack ''em up men--became associated with anatomy and surgery departments of medical schools. The practice still persists in many countries across the world, especially developing countries.1–5 In countries such as Pakistan, medical institutions may not be able to afford scientific tools, including bones required for anatomical studies. In Pakistan, anatomy and osteology form a major part of exams and carry a large percentage of marks. There's a widespread belief among students that if you don't have important learning resources your academic career may be jeopardised and without proper anatomical knowledge you are an “incomplete” doctor. However, bones in medical schools are in short supply, and there aren't enough for students to study.6 Medical faculties allow students to study bones only during routine hours and forbid students from taking bones out of the college building. Students therefore feel the necessity to obtain skeletons themselves, as they aren't able to understand osteology in such short spans of time to get a clear picture of human anatomy. As a result, students …

4 citations


Journal Article
TL;DR: Myelography is the least expensive valuable diagnostic test in spinal disorders specially in lumbar disc prolapses and lumbr canal stenosis.
Abstract: Objective: To evaluate the diagnostic importance of myelography in spinal disorders, in correlation with clinical presentation of the patients. Methods: Patients selected for myelography had presented with history of various spinal disorders such as low backache, neurogenic claudication, paraparesis or paraplegia, quadriparesis or quadriplegia, trauma to spinal region and infective spondylitis. Patients excluded were those with history of allergies to iodinated contrast agents, seizures coagulopathy and pregnant women. Contrast agent was water soluble non ionic agent - lohexol. Spinal Needles used were of 20,22 and 25 gauge. X-Ray machine with tilltable table was used for myelography. Results: There were 1400 patients of whom 935 were males and 465 females with male to female ratio of 2.1. Age range was 8 to 65 years. Spinal disorders diagnosed on myelography were lumbar disc prolapse 866 (60%) cases, lumbar canal stenosis 113 (8%), thoracic disc protrusions 15 (1%), infective spondylitis 53 (4%) cases, spinal tumors 36 (2.5%), spinal dysraphism 28 (2%) and traumatic spine in 85 (6%) cases. Free flow of contrast agent with no block was found in 149 (10.64%) cases. These were subjected for MRI scan which revealed significant pathological lesion of surgical importance in 23 cases (1.64%) only. Conclusion: Myelography is the least expensive valuable diagnostic test in spinal disorders specially in lumbar disc prolapses and lumbar canal stenosis.

3 citations