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Objective: To assess the early complications of surfactant administration in neonates with respiratory distress syndrome. Study Design: Perspective longitudinal study. Place and Duration of Study: Pak Emirates Military Hospital (PEMH), Rawalpindi Pakistan, from Jun to Dec 2021. Methodology: A total of 64 neonates admited in ICU with gestational age 27-32 weeks requiring Continuous Positive Airway Pressure and surfactant administration were included. Neonatal complications after 24 hours of administration of surfactant and final outcome was recorded on a predesigned data colection tool. Results: Mean duration of stay on ventilator was 41.12±8.88 hours. Mean duration for Continuous Positive Airway Pressure was 43.59±22.70 hours. Second dose of surfactant was given to 34(53.1%) of neonates. Among neonates 25% suffered from pulmonary hemorrhage and 7.8% from bradycardia, 48(75%) were discharged and 16(25%) died. Conclusion: The mortality rate decreased in neonates after administration of surfactant. In future, we wil implement surfactant in term neonates, diagnosed with Respiratory Distress Syndrome, in order to improve the survival of neonates and reduce complications. [ABSTRACT FROM AUTHOR]

We present disseminated intravascular coagulation (DIC) with excessive fibrinolysis (XFL) as an unusual presenting manifestation of metastatic prostate cancer (PC), which was successfully treated with chemotherapy with Docetaxel which not only controlled the disease but also reversed the patient's coagulopathy within seven days effectively. Thus highlighting rare and life-threatening haemorrhagic complications of prostate cancer along with its satisfactory management option. [ABSTRACT FROM AUTHOR]

Objective: To determine the diagnostic accuracy of the Mentzer index as a screening tool for iron deficiency anaemia, using an iron profile as the gold standard in patients presenting with hypochromic microcytic anaemia. Study Design: Cross-sectional study. Place and Duration of Study: Department of Pediatrics, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2021 to May 2022. Methodology: Data was collected from 163 patients with hypochromic microcytic anaemia. Red cell indices were noted for each patient and recorded on a defined proforma. Results: The mean age of the patients was 8.23±3.57 years. 85(52.1%) patients were males and 78(47.9%) were females. Moreover, out of 163 patients, the specificity, sensitivity, negative predictive value, positive predictive value, and diagnostic accuracy of the Mentzer index for the diagnosis of iron deficiency anaemia were 90.1%, 90.1%, 84.6%, 93.8%, and 90.8%, respectively. Conclusion: The cell-count-based indices, especially the Mentzer index, are reliable and available methods for diagnosing iron deficiency anaemia. They have an accurate discrimination ability. [ABSTRACT FROM AUTHOR]

Objective: To investigate the dependency on feeding gastrostomy tubes in patients with head and neck cancers treated with radiotherapy alone or concurrent chemo-radiotherapy. Study Design: Retrospective longitudinal study. Place and Duration of Study: Combined Military Hospital, Rawalpindi and Shaukat Khanum Hospital, Peshawar Pakistan, from Jan and Jul 2022. Methodology: A total of 115 patients with head and neck cancers having no baseline dysphagia and having gastrostomy tubes were included. All had received an equivalent of 60 greys in 30 fractions or more of radiotherapy. Their swallowing was evaluated weekly during radiotherapy and then every 4-6 weeks on post-treatment follow-up. The total time duration of patient dependency on feeding gastrostomy tube after treatment completion was noted for each head and neck cancer subsite. Results: Of a total of 115 patients, 49(43%) of the patients had nasopharyngeal cancers, 22(19%) had laryngeal, 29(24%) oral cavity, 7(6%) hypopharyngeal and 9(8%) had cervical esophageal cancers. Proportion retaining gastrostomy tube for more than six months of treatment was 8.7% (median duration of retention was five months) with hypopharyngeal, nasopharyngeal, oral cavity, and laryngeal cancer were 14%, 9%, 9% and 5%, respectively. Conclusion: The proportion of patients with head and neck cancers requiring more than six months of a gastrostomy tube is 5-14%. Baseline assessment of swallowing and nutrition and prophylactic feeding gastrostomy can avoid treatment interruptions. Longer duration of retention of a gastrostomy tube is associated with poor quality of life in head and neck cancer patients receiving radiation or concurrent chemo-radiation. [ABSTRACT FROM AUTHOR]