Fatema Jawad ( 7/6, Rimpa Plaza, M. A. Jinnah Road, Karachi. )
PATTERN OF THYROID DISEASES - A STUDY OF 203 CASES IN JINNAH POSTGRADUATE MEDICAL CENTRE (JPMC), KARACHI. Malik, K., Channa, AL, Khan, A. and Waheed, I. The J. Surg. PIMS., 1992;3&4: 17-19.
All patients with goitre, admitted to the surgical wards of JPMC from January, 1988 to December, 1990 were analysed for the pattern of prevalent thyroid disease. There were 170 females and 33 males with their ages ranging between 13 and 75 years. Besides a detailed physical examination all cases were subjected to indirect laryngoscopy to assess the mobility of the vocal cords. Serum T3, T4 and TSH was done in all patients andx-ray of the neck in those cases where retrosternal extension was suspected. Nodular goitre was found in 48.7% of the cases whereas 25.6% had multinodular goitre. The incidence of malignancy was 11.4% with papillary carcinoma being 5.4%. This figure is less than that reported in other studies. The large number of females being affected is attributed to the repeated stimulation, of the thyroid gland before each menstrual cycle and the sustained demand of thyroxine during pregnancy.
CORRELATION OF ENDOSCOPIC FINDING WITH HISTOLOGICAL, DIAGNOSIS IN GASTRITIS. Manan, A. and Ahmed, S.J. Ayub Med.Coll., 1991;4:35- 38.
The study was conducted to correlate the endoscopic findings and histological changes in clinically diagnosed gastritis cases. 25 patients, 14 males and 11 females, were endoscoped and 2 biopsy specimens taken from the suspected area and subjected to histological examination after fixing in 10% buffered formalin. The endoscopy showed 13 cases as severe gastritis, 5 as generalised gastritis with erosion and 7 had minimal gastritis. The histology results revealed pathological changes in 19 cases whereas 6 had no evidence of the disease. Thirteen patients with severe gastritis were histologically diagnosed as acute gastritis 7 cases, gastritis with erosion 2 cases, chronic superficial gastritis 3 cases and chronic atrophic gastritis 1 case. Five patients with generalised gastritis and erosion had a final diagnosis of 2 with chronic atrophic gastritis, one acute gastritis and 2 showed no histological change. 7 subjects labelled as minimal gastritis were classified as 3 acute gastritis and 4 had a normal histological finding. It was thus concluded that due to a great discrepancy between clinical symptoms, endoscopic diagnosis and histological findings, it is imperative to determine a final diagnosis by combining the endoscopy observations with the histopathology result.
FLUOXETINE IN THE TREATMENT OF DEPRESSION. Haider, I. The Pak.J.Clin.Psychiat., 1991;1: 133-134.
Fluoxetine, a new antidepressant drug was tried on 46 patients, diagnosed as primary depressive illness, had not received ECT in the past 3 months and had not had any anti depressive medication. Only 40 cases completed the trial of 3 weeks and of these 28 were males and 12 females. Their ages varied from 26to 64years. Fluoxetine was started in a dose of 20 mg daily and assessment was made according to the Medical Research Council rating scale on days 0, 4,7, 10, 14 and 21. A marked improvement was noted in the symptoms of depressed mood, anxiety and agitation. Seventy five percent of the cases had very much improved, 20% showed no change and 5% became worse. The side effects reported were nausea, headache, nervousness, insomnia, drowsiness, dizziness and irritability all of which were relieved on dose reduction. The 6 patients who dropped out were 2 due to anxiety, one because of excitability, one felt worse and 2 found the drug expensive. The analysis of the results proved fluoxetine to be an effective antidepressant.
A STUDY OF SINGLE DOSE OF CO-TRIMOXAZOLE AND CLINDAMYCIN IN PREVENTING APPENDECECTOMY WOUND INFECTION IN NON-PERFORATED APPENDICITIS (A CONTROLLED TRIAL). Rasool, M.I., Iqbal, M., Anwar, M.I., Malik, S.H., Rashid, M. and Zaidi, A. Pak.J.Pathol., 1992;3:33-36.
A double blind randomized trial of a single prop hylactic dose of an antibiotic in 159 patients, 122 males and 37 females of acute non-perforated appendicitis was carried out in the department of surgery, Rawalpindi General Hospital, Rawalpindi between January, 1987 and June, 1988. The average age of the patients was 22.21 years. The diagnosis was made on clinical grounds and the patients were randomly divided into 3 groups. The first group of 40 patients was the control with no antibiotic. Group II had 50 cases who were given a single i/v dose of co-trimoxazole (80 mg trimethoprin and 400 mg of suiphamethoxazole) and 60 cases in group III received a single i/v dose of 300 mg clindamycin phosphate. Appendicectomy was performed through a grid iron incision using the conventional technique by the resident staff. The visiting surgeons inspected the wound on the fourth day. The presence of a purulent discharge caused the wound to be labelled as infected and classification was done after the reports of the culture and sensitivity test. Anaerobic cultures were not possible due to lack of facilities. Twelve appendicectomy wounds were found infected. 7 cases in group I, 2 in group II and 3 in group III developed the infection. Proteus vulgaris and E. coli were cultured from 4 wounds whereas 8 showed no growth and they were presumed to be due to anaerobes. It has been well established that both aerobes and anaerobes cause appendicitis and the role of endogenous bacterial contamination in the production of post-operative wound infection is also proved. The presence of antibiotic in the tissues at the time of surgery saves long term antibiotic use and prophylactic presence of one dose of co-trimoxazole or clindamycin preoperatively, prevents wound infection.