scholarly journals Primary Hyperparathyroidism: Experience from a Tertiary Care Centre in Pakistan

2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Tehseen Fatima ◽  
Bhagwan Das ◽  
Saadia Sattar ◽  
Najmul Islam
Keyword(s):  
Primary Hyperparathyroidism ◽  
Tertiary Care ◽  
Disease Recurrence ◽  
Vitamin D Supplementation ◽  
University Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Creative Commons ◽  
Musculoskeletal Manifestations ◽  
High Index Of Suspicion

Objective: To study the clinical, biochemical and radiological features and management outcomes of patients with primary hyperparathyroidism. Methods: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, Pakistan and comprised data of patients with primary hyperparathyroidism from 2008 to 2017. Results: Out of 103 patients, 83(80.6%) were female. Overall mean age was 59.3±16.2 years. Musculoskeletal manifestations were seen in 60(58.3%) patients and renal manifestations in 28(27.2%). Ostieits fibrosa cystica was found in 04(3.88%) patients. Overall, Ultrasound neck and sestamibi scan localized the lesion in 66 (64.1%) and 77 (76.2%) patients respectively. Among 79 patients who underwent surgery, 67 (84.8%) patients had an adenoma, 05 (6.3%) had hyperplasia and 02(2.53%) patients had parathyroid carcinoma whereas histopathology was inconclusive in 5 (6.32%) out of the 79 surgically treated patients. Disease recurrence was seen in 13 out of 79(16.45%) patients who underwent surgery. Conclusion: Primary hyperparathyroidism is associated with significant morbidity in our population. Targeted measures like improving patient awareness, routine calcium screening, vitamin D supplementation and a high index of suspicion by the clinician may help in early diagnosis of the condition and thus reduce morbidity. doi: https://doi.org/10.12669/pjms.36.6.2572 How to cite this:Fatima T, Das B, Sattar S, Islam N. Primary Hyperparathyroidism: Experience from a Tertiary Care Centre in Pakistan. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.2572 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Tubercular mastitis: An institutional experience from a tertiary care centre of northern India

2017 ◽  
Vol 8 (3) ◽  
pp. 72-75
Author(s):  
Amit Gupta ◽  
Lovenish Bains ◽  
Deepshikha Yadav ◽  
Prashant Durgapal ◽  
Manish Kumar Agrawal
Keyword(s):  
Tertiary Care ◽  
Needle Aspiration ◽  
Care Centre ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Aspiration Cytology ◽  
Northern India ◽  
Institutional Experience ◽  
Needle Aspiration Cytology ◽  
High Index Of Suspicion

Background: Tuberculous mastitis (TM) is a rare extra pulmonary presentation of tuberculosis. It may be problematic to distinguish from carcinoma breast, a condition with which it may coexist.  Fine needle aspiration cytology (FNAC) / biopsy are indispensable for diagnosis and tuberculosis culture when positive may be very valuable to guide antimicrobial therapy.Aims and Objectives:  To disseminate the message to the concerned expertise that it can present a diagnostic problem on radiological and microbiological investigations, and thus a high index of suspicion is needed.Materials and Methods: 19 cases of tubercular mastitis between  January 2012 to March 2014 were identified and included in the present study. Cytology and biopsy alongwith AFB stain was done for confirmation.Results: Age ranged between 23- 55 years (median 33 years). Axillary nodes were palpable in 9 (47.3%) patients. Acid Fast Bacilli stain which was positive in only 3 patients. All the 19 patients were started on antitubercular treatment.Conclusion: This study highlights the importance of early diagnosis and aggressive medical and if required surgical management to cure this disease.Asian Journal of Medical Sciences Vol.8(3) 2017 72-75

scholarly journals Self-Diagnosis of Surgical Site Infections: Lessons from a Tertiary Care Centre in Karachi, Pakistan

2019 ◽  
Vol 36 (ICON-Suppl) ◽  
Author(s):  
Sana Z Sajun ◽  
Katherine Albutt ◽  
Umme Salama Moosajee ◽  
Gustaf Drevin ◽  
Swagoto Mukhopadhyay ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Post Discharge ◽  
Creative Commons ◽  
Surgical Workforce ◽  
Special Supplement

Background and Objective: Surgical site infections (SSIs) usually manifest post-discharge, rendering accurate diagnosis and treatment challenging, thereby catalyzing the development of alternate strategies like self-monitored SSI surveillance. This study aims to evaluate the diagnostic accuracy of patients and Infection Control Monitors (ICMs) to develop a replicable method of SSI-detection. Methods: A two-year prospective diagnostic accuracy study was conducted in Karachi, Pakistan between 2015 and 2017. Patients were educated about SSIs and provided with questionnaires to elicit symptoms of SSI during post-discharge self-screening. Results of patient’s self-screening and ICM evaluation at follow-ups were compared to surgeon evaluation. Results: A total of 348 patients completed the study, among whom 18 (5.5%) developed a SSI. Patient self-screening had a sensitivity of 39%, specificity of 95%, positive predictive value (PPV) of 28%, and negative predictive value (NPV) of 97%. ICM evaluation had a sensitivity of 82%, specificity of 99%, PPV of 82%, and NPV of 99%. Conclusion: Patients cannot self-diagnose a SSI reliably. However, diagnostic accuracy of ICMs is significantly higher and they may serve as a proxy for surgeons, thereby reducing the burden on specialized surgical workforce in LMICs. Regardless, supplementing post-discharge follow-up with patient self-screening could increase SSI-detection and reduce burden on health systems. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1716 How to cite this:Sajun SZ, Albutt K, Moosajee US, Drevin G, Mukhopadhyay S, Samad L. Self-Diagnosis of Surgical Site Infections: Lessons from a tertiary care centre in Karachi, Pakistan. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S55-S60.  doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1716 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract #1100: Tumor Induced Osteomalacia: Clinical; Biochemical and Radiological Features from a Single Tertiary Care Centre with Emphasis on Functional Imaging.

2017 ◽  
Vol 23 ◽  
pp. 289
Author(s):  
Vineet Surana ◽  
Rajesh Khadgawat ◽  
Nikhil Tandon ◽  
Chandrashekhar Bal ◽  
Kandasamy Devasenathipathy
Keyword(s):  
Functional Imaging ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Radiological Features

Emerging Antimicrobial Resistance Among Methicillin Resistant Staphylococcus Aureus (MRSA) in a Tertiary Care Centre in North India

JMS SKIMS ◽  
2020 ◽  
Vol 23 (1) ◽  
pp. 48-49
Author(s):  
Javaid Ahmad Bhat ◽  
Shariq Rashid Masoodi
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Tertiary Care ◽  
Resistance Mechanisms ◽  
North India ◽  
Global Public Health ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Effective Prevention ◽  
Mupirocin Resistance

Apropos to the article by Dr Bali, titled “Mupirocin resistance in clinical isolates of methicillin-sensitive and resistant Staphylococcus aureus in a tertiary care centre of North India” (1), the authors have raised important issue of emerging antimicrobial resistance (AMR). Antimicrobial resistance is an increasingly serious threat to global public health that requires action across all government sectors and society. As per WHO, AMR lurks the effective prevention and management of an ever-increasing spectrum of infections caused by bacteria, parasites, fungi and viruses. Novel resistance mechanisms are emerging and spreading globally, threatening the man’s ability to treat common infectious diseases.

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