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Objective: The aim of this study is to present six cases of cervical lymphadenopathy, diagnosed as Kikuchi's disease and raise the index of suspicion for this disease. Study Design: Case Series. Setting: Histopathology and Otolaryngology/Head & Neck Surgery Department at Rehman Medical Institute (RMI) Peshawar. Period: July 2016 to March 2021. Material & Methods: Records of patients for cases diagnosed as "histiocytic necrotising lymphadenitis" were retrieved, their corresponding patient files accessed from the archive, and case notes analyzed. Results: In this series, a total of six cases of Kikuchi's disease are presented. A female predominance is evident from the present data (2:1 female to male ratio). All patients presented with palpable lymph nodes in the neck, predominantly on the left (66.7%). Majority (66.7%) presented with neuralgic pain (on/off). Only one patient did not show weight loss and night sweating, the remaining had all the symptoms. All of the patients recovered spontaneously within 6 months (range 2 to 6 months) with symptomatic treatment for neuralgic pain. Conclusion: Kikuchi's disease should be kept in the differential diagnosis in young females with persistent neck masses, palpable lymph nodes and suspicious fine needle aspiration cytology (FNAC). [ABSTRACT FROM AUTHOR]

Objective: To account for the characteristic presentations, pathology and the post-operative complications of surgical treatment of retrosternal goitre. Study Design: Retrospective Descriptive study. Setting: Department of Otorhinolaryngology at Rehman Medical Institute, Peshawar. Period: July 2016 and December 2019. Material & Methods: All patients that underwent thyroidectomy during the study period were included in the study. The thyroid gland that did not have retrosternal extensions were excluded. Retrospective chart records of all these patients were analysed. Data obtained from the charts was recorded on Statistical package for social services version 23.0 and analysed for descriptive statistics. Results: 67 patients with goiters were at the tertiary care center of Peshawar, females (77.6%) and males (22.4%). 6 (8.9%) were retrosternal. The most common symptoms were neck swelling (83.3%) followed by shortness of breath (66.7%). Post-operative hypocalcaemia was the most common complication among retrosternal thyroidectomy patients (66.7%). Only one patient needed sternotomy. Conclusion: All patients with retrosternal goitre should be offered surgery. The post-operative complications are low and resolve uneventfully. [ABSTRACT FROM AUTHOR]

The objective of the current study was to estimate the frequency of pediatric dyslipidemia in overweight and obese students of private schools in Swat. Study Design: Questionnaire based cross-sectional study. Setting: Three private schools of district Swat. Period: 6 months. Materials and Methods: Study analysis was done in Research laboratories of Biochemistry Department, Institute of Basic medical Sciences (IBMS), Khyber Medical University Peshawar. Well-designed questionnaires were used for screening of 99 out of 1374 students, including both girls and boys. Anthropometric measurements were taken. Blood samples were collected for the analysis of serum lipids using an Automated Cobas Analyzer. SPSS version 20, Student's t test and Logistic regression method was used for statistical analysis. Results: The prevalence of dyslipidemia was measured to be 42.4%. A significantly direct association was found between the rate of dyslipidemia and BMI. Highly significant P values were found for serum lipids in obese children as compared to overweight children thus showing strong association between the biochemical Parameters and BMI. Even though rate of dyslipidemia was measured to be a little higher in boys as compared to girls, no statistically significant gender differences were found in serum lipid levels. Conclusion: Reduce long-term complications in adulthood is possible through controlling the serum lipid levels of children and adolescents. [ABSTRACT FROM AUTHOR]

Background: The histological pattern and frequency of glomerular diseases differs according to the geographic area, race, age and indications for renal biopsy. This study was conducted to evaluate the frequency of different histological patterns of glomerulonephritis during a 10 years period at our institute. Study Design: Retrospective Case series. Period: 1st January 2007 to 31st, December 2017. Study Setting: Institute of kidney diseases, Hayatabad Medical Complex Peshawar, Pakistan. Results and Discussion: Clinical records of 415 native renal biopsies performed in patients with mean age 27.17 ± 14.98 years were included in this study. Males were 266 (64.1%) and females 149 (35.9%). Data was analysed for three age groups separately, Children (<18 years) 147 (35.5%), Adults (18-59 years) 253 (61.0%) and elderly (>60 years) 15 (3.6%). Primary GN (glomerulonephritis) was the most common (74.21%) followed by secondary GN (26.41%). Among primary glomerular diseases, Focal segmental glomerulonephritis (FSGS) was (29.6%), membranoproliferative glomerulonephritis (MPGN) also known as mesangiocapillary glomerulonephritis constituted 19.5% and Membranous glomerulonephritis (MGN) was the third most common (16.6%). Among secondary GN, acute tubular necrosis (ATN) was the most common (25.4%), followed by amyloidosis (14.7%), hypertensive nephropathy (13.7%) and lupus nephritis (12.8%) respectively. There was a slight male predominance in all types of primary GN except for focal necrotizing GN and most of the secondary types except lupus nephritis and chronic tubulointerstitial nephritis (TIN). Below 18 years, MPGN was (58.3%), focal necrotising GN (57.1%) and minimal change disease (MCD) was (52.2%). Crescentic GN (89.5%), MGN (74.5%), immunoglobulin A (IgA) nephropathy (72.7%), chronic sclerosing GN (CSGN) (64.7%) and FSGS (56%) were more common in adults. Frequency of immunoglobulin M (IgM) nephropathy (50%) was equal in children and adults. In elderly patients, the commonest GN reported was hypertensive nephropathy (28.6%), amyloidosis (6.7%) and MGN (5.9%). Conclusion: Among the wide variety of histological patterns, FSGS was the commonest GN in adults followed by MPGN and MGN. Among adults, primary GN was more common. When compared with other studies, FSGS is more common in the present study and some Indian studies, while membranous GN is more common in other regional countries. [ABSTRACT FROM AUTHOR]

Objectives: To determine the diagnostic accuracy of C-reactive protein in the diagnosis of neonatal sepsis keeping blood cultures as gold standard. Study Design: Descriptive cross-sectional study. Setting: Pediatric Unit of Lady Reading Hospital Peshawar Pakistan. Duration: Six months from 09-06-2012 to 08-12-2012. Methodology: Total of 196 patients meeting the required inclusion criteria with clinical suspicion of sepsis. Those neonates were subjected to investigations. C.R.P. was tested using the Quantitative method according to the instructions provided with the kit. By keeping blood culture as gold standard, patients with both positive and negative cultures were taken and the results compared to the results of C.R.P. in these subjects being positive or negative. Results: Among the 196, majority of the neonates included were less than a week old having a mean age of 4.5 days. There were 57 (29%) females and 139 (71%) males, with male to female ratio of 2.4:1. Blood cultures were positive in 85 (43%) and negative in 111 (57%) cases, while C.R.P. was positive in 95 (48%) and negative in 101 (52%) cases. Sensitivity, specificity, and positive and predictive values of C-reactive protein were calculated using formulas, and they turned out to be 77.6%, 73.8%, 69.4%, and 81.2% respectively with accuracy being 0.41%. Conclusion: An accurate and timely diagnosis of early onset neonatal sepsis remains challenging to the clinician as well as laboratory. Physicians can prevent unnecessary antibiotic use by performing the qualitative estimation CRP as a single, rapid and inexpensive test with a negative predictive value of 81.2%. [ABSTRACT FROM AUTHOR]

Objectives: To study the frequency of different types of bacteria causing sepsis in neonates, their sensitivity and resistance to various antibiotics in common practice at a tertiary care hospital. Study Design: Prospective cross-sectional study. Stetting and Duration of study: The study was conducted in Neonatal unit, Lady Reading Hospital, Peshawar, Pakistan from January to October 2017 (10 months duration). Material and Methods: Blood culture positive neonatal sepsis patients admitted to the Nursery C, LRH during 10 months were analyzed for bacteria and their sensitivity/resistance pattern. Results: During study period total 115 blood culture proven neonatal sepsis causes were found. Only 3 pathogens were isolated, where E. Coli was the most frequent organism found in 85 cases. Staphylococcus aureus (25Cases) was the second frequently occurring organism while Klebsiella spp. was the third pathogen causing sepsis in my study (7 cases). Amikacin (88% sensitive against E. Coli), vancomycin (100% sensitive against Staphylococcus aureus) were found most sensitive than commonly used antibiotics. As the organisms were mostly resistant to ampicillin (76.23%) Amoxicillin (82.48%), Cefotaxime (93.75%) and Ceftriaxone (66.29%), Ceftazidime was comparatively less resistant (55.80%). Conclusion: E. Coli was found to be the major cause for neonatal sepsis followed by Staphylococcus aureus in admitted neonates at Lady Reading Hospital. An alarming increase in the resistance pattern of empirically used antibiotics was observed. So, there is dire need for continuous monitoring/surveillance of this alarming resistance of commonly used drugs. Moreover, an effective infections control program is needed to limit the spread of resistant strains of these pathogens. [ABSTRACT FROM AUTHOR]

Background: Neonatal jaundice is a common condition in the early days of infant's life. It clinically manifests in a significant number of full term babies and almost all premature neonates. Increase in the serum bilirubin during early infancy is multi factorial and may result in kernicterus. Deposition of unconjugated bilirubin in the brain stem nuclei and basal ganglion results in permanent brain damage. Objective: To determine the frequency of common hemolytic causes of hyperbilirubinemia in full term neonates requiring exchange transfusion. Study Design: Cross-sectional study. Setting: Department of Pediatrics, Lady Reading Hospital Peshawar. Period: January to June 2015. Methodology: A total of 449 full term neonates requiring exchange transfusion were included in this study on the basis of serum bilirubin level (total, direct, indirect). Hemolytic causes were analyzed by checking blood groups, rhesus factors and measuring glucose 6 phosphate dehydrogenase (G6PD) levels. Results: In this study mean age was 10 days with standard deviation ± 1.26. Sixty two percent neonates were male and 38% were female. Hemolytic causes were analyzed and ABO incompatibility was found in 25% neonates, rhesus incompatibility in 15% neonates and G6PD deficiency in 32% neonates. Conclusion: In this study, the most common cause of severe jaundice requiring exchange transfusion was G6PD deficiency (33%) with hemolysis. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the birth weight in infants born to diabetic mothers and to compare it with those born to nondiabetic mothers. Study Design: Descriptive cross sectional study. Setting: Gynae and obstetrics unit Hayatabad Medical Complex Peshawar in association with Anatomy Department Khyber Girls Medical College Peshawar. Period: January 2015 to June 2015. Material and Methods: This study was carried out on babies born to diabetic as well as non-diabetic healthy mothers. A total number of 100 diabetic mothers and 100 nondiabetic healthy mothers were selected for this study. After delivery, the weight and sex of the babies born to diabetic as well as nondiabetic mothers along with the mother's age were noted on an observation sheet. The student's t test was applied for all quantitative data. A p-value of = 0.05 was taken significant. Results: The mean birth weight of female babies born to diabetic mothers was significantly greater than babies of nondiabetic mothers (p= 0.05). No significant difference (p=0.11) was noted when the birth weight of all babies born to diabetic mothers was compared to all babies born to nondiabetic mothers. No significant difference (p= 0.51) was noted in babies belonging to younger nondiabetic and diabetic mothers but a significant difference (p=0.01) was noted when birth weight of babies from older nondiabetic mothers was compared with birth weight of babies from older diabetic mothers. Conclusion: The birth weight of female babies born to diabetic mothers was significantly more as compared to babies born to nondiabetic mothers. A significant difference was also noted when birth weight of babies from older diabetic mothers was compared with the babies of older nondiabetic mothers. This larger weight of babies may be due to maternal diabetes which may affect the normal development of fetus leading to an increased morbidity and mortality in babies as well as mothers. [ABSTRACT FROM AUTHOR]