Search

Objectives: To identify the etiology and outcomes of new onset seizure in adult patients presenting to the Emergency Department (ED), to improve knowledge among healthcare providers regarding diagnosis and hence improve the outcomes. Methods: This was a descriptive retrospective study conducted at the Emergency Department of Aga Khan University Hospital, Karachi, Pakistan. Adult patients (18 years and above), presented to the ED from January 01, 2019 to June 30, 2020, with new onset seizure were included consecutively. Descriptive data on patient demographics, seizure types, investigations performed, final diagnosis and disposition were collected retrospectively from patient's file and electronic record. Etiologies of seizure were classified as structural (metabolic, trauma, infection), genetic or idiopathic. The immediate outcomes were reported as hospitalization or discharge from the ED. Results: In total 198 patients with new onset seizure were included. Majority of the patients were found in middle age group i.e., 35 to 65 years (44.4%). Gender distribution showed slightly higher percentage of females (55.1%). Generalized tonic clonic seizures were found to be the most common type of seizures (74.2%), followed by generalized tonic (12.1%) and focal onset aware seizures (7.5%). Out of total patients no cause was identified in eight patients (4%), whereas in total confirmed causes of new onset seizures, structural lesions of brain were found to be the most common cause (89.6%%), including neurological (23.6%), infectious (4.2%), systemic (13%), metabolic (7%) and toxicological (4%) causes respectively. Conclusion: This study explores the various etiologies of new onset seizures in adult patients presenting to the ED. The study emphasizes the need for a local guideline for the investigation of new onset seizures in adult patients that would direct emergency physicians in respect of appropriate management, thus to ensure better quality of patient care and outcomes. [ABSTRACT FROM AUTHOR]

Objective: Burns are important contributors toward mortality in trauma related injuries in Karachi, Pakistan. The aim of the present study was to delineate the factors contributing to the duration of hospitalization and mortality in such patients. Methods: We performed a single center retrospective study of patients admitted during a 2 year period (January 2009 till December 2010) in Burns Center, Karachi. Patients with incomplete record were excluded. Variables included were age and gender of the patient, the percent total body surface area (%TBSA) burn, the cause of the burn and the body parts affected along with the micro-organisms isolated from the burn wounds. The relationship of these variables with the duration of hospitalization and the outcome of patients was assessed by means of Pearson Chi Square test in SPSS version 14. Results: Mean age of patients was 26.64 years (±13.430). More males (56.6%) were admitted than females (43.4%), giving a male to female ratio of 1.3:1. Mean percent total body surface area (%TBSA) burnt and mortality were 24.69% and 26.38% respectively with both having higher values in females (p <0.001). Males had a mean longer duration of hospitalization compared to females (35.94 days vs. 27.63 days). The most common micro-organism colonizing the wounds was found to be Staphylococcus aureus. Factors significantly (p <0.05) associated with increased duration of hospitalization and mortality include the age and gender of the patient, the cause of burn, inhalation injury, the region affected and %TBSA burnt. Conclusion: The relationship of age and gender of the patient, the cause of burn, inhalation injury, the region affected and %TBSA burnt are important factors in determining the duration of hospitalization of the patients and whether the patients will survive or succumb to injuries. [Copyright &y& Elsevier]

Background: To determine the behavior of physicians regarding medical literature reading and participation in research activities at one of the largest teaching hospitals in Pakistan. Method: This descriptive, cross-sectional study was conducted by interviewing the house officers, residents and fellows of six major specialties (Medicine, Surgery, Pediatrics, Psychology, Obstetrics & Gynecology and Anesthesia) in Civil Hospital, Karachi between August and December, 2011. The questionnaire elicited responses regarding the reading habits of physicians, preferred sources of information, their participation in research activities (publication & supervision) and views regarding journal club. SPSS 17.0 was used for data entry and analysis. Result: A total of 259 completely filled questionnaires were returned with a response rate of 85.19%. Mean age of the participants was 29.67 ± 7.65 years. Books were selected by 71.4% doctors as their preferred source of information, regardless of their clinical specialties. (p<0.05). E-journals were preferred by 75.7% of the doctors over printed journals. This holds true for doctors from all specialties (p<0.05). The ease of searching for relevant articles was the major contributor (50.5%) in preference of e-journals. 137 (52.9%) doctors read 5 or less articles per week. 30 (11.6%) doctors have subscription of journals (printed or electronic). At least one research paper has been published by 151 (58.3%) of the physicians interviewed. Most common reason for not participating in research activities was busy schedule (56.4%). Almost half (49.4%) doctors reported lack of journal club in their units. Of these, majority (88.35%) wanted a journal club in their respective units. Conclusion: Urgent intervention is required to promote healthcare literature reading and writing practice in our physicians. Easy access to workplace computers with internet and subscription of paid journals will facilitate physicians. Lack of supervisors and busy schedule were reported to be important contributors for not participating in research. Addressing these issues will encourage doctors to participate more in research activities. [ABSTRACT FROM AUTHOR]

Objective: To assess the etiological factors and circumstances associated with the occurrence of eye injuries in children attending a tertiary care pediatric ophthalmology department. Methodology: This study was conducted at the Department of Pediatric Ophthalmology, Civil Hospital, Karachi from August 2007 to July 2009. Personal information, clinical findings and management plan was recorded on a prescribed performa. Variables studied included: age, sex, date of injury, place of injury, involved eye, circumstance and mechanism of injury, initial visual acuity and immediate management. Results: A total of 462 patients under the age of 16 years presented with ocular trauma. There were 297(64.3%) males and 165(35.7%) females. Mean age was 7.03 ± 3.61 years. Most cases 198 (42.9%) belonged to the schoolgoing age group (6 to 11years). The injuries occurred most frequently at home (215 patients, 46.5%).Blunt trauma occurred in 228(49.4%) cases followed by penetrating in 162(35.1%) cases. Injuries restricted to the eyelid occurred in 61 (13.2%) accidents, closed globe injury occurred in 338 (73.1%) and open globe injury in 63 (13.7%) accidents. Visual acuity was better than 6/12 in 245 (53.0%) children. Two hundred and fifteen children (46.5%) were prescribed only general measures like pressure patching, warm or cold compresses antibiotics or lubricant eye drops. Surgical management was required in 121(26.2%) patients. Conclusions: This study has shown frequencies of different type of ocular trauma which can be minimized by taking preventive measures as adopted in developed countries. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the awareness of patients suffering from hepatitis, relating to the modes of transmission, vaccination and treatment of hepatitis B & C. METHODS: A close-ended questionnaire was administered to patients suffering from hepatitis, who were at the Chief Minister's Hepatitis Program for free therapy. Informed verbal consent was obtained. Questions were asked in native language and filled in by the medical students based on patient responses. Frequencies of responses were calculated and compared by gender. RESULTS: A total of 195 patients' responses were recorded during the study period of two weeks. 81.0% understood that it could be transmitted through needle piercing, and 79.0% similarly felt that the disease can spread through sharing of razors. However, knowledge and coverage of vaccination for HBV was poor, with only 20.5% of the patients having been vaccinated, and 25.6% had any of their family members vaccinated. Only 14.4% of the patients correctly knew that there was an existing vaccine for HBV, whereas there was no vaccine for HCV. 70.8% knew that the disease could lead to cancer, and 71.3% thought that ascites could be another complication of the disease. CONCLUSION: Patients seemed to have some general knowledge regarding transmission and complications of HBV and HCV, however steps need to be taken in the future to ensure better coverage of the vaccine. The public needs to be educated further with respect to spread and especially vaccines, or the patients suffering from HBV and HCV will continue to rise in the future. [ABSTRACT FROM AUTHOR]