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Abstract

A Study of Hundred Cases of Acute Leukaemia In Northern Pakistan with reference to French- American and British (FAB) Cooperative Group Classification. Alvi, E.A., Saleem, M., Ahmad, P., Rehinan, Z., Anwar, M., Ahmad, M. Pak.J. Pathol., 1990;1:87-92.
The clinico-pathological features of 100 cases of severe aplastic anaemia (SAA), diagnosed by using the Cammitta criteria are presented. A detailed history was obtained from each case and all underwent a physical examination. Four groups were formed according to the symptoms. Group A comprised of patients having symptoms and signs secondary to anaemia. Group B had patients who presented with haemorrhagic manifestations, group C came with a history of prolonged fever and repeated infections and group D had cases presentingwith signs and symptoms of both bleeding and infection. Blood counts were performed on the Coulter counter and smears of bone marrow aspirates were stained with Leishmania’s stain. The mean age of the cases in group A was 27 years, group B 19 years, group C, 32 years and group D, 11 years. Group A had the longest duration of symptoms with group D presenting with mtmum depression of erythropoiesis. A positive causa­tive agent could be established in half of the cases in group C and A. The maximum blood transfusions were required by group B and D. The study concluded that majority of the SAA cases in Northern Pakistan belong to the younger age group, males outnumber the females and the disease is of a more severe form in these cases. The presenting symptom is mostly a bleeding disorder and the majority of the younger patients have idiopathic SAA. These features differ from those encountered in the western world but resembles SM in the countries of the eastern hemi­sphere.
Endemic Goitre: An Affliction of Young Females In Murree Hills. Zafar, A., Cheema, K., Akhtar, S.S., Latif, S., Sadiq, KJ. Pak. Instit. Med Sci., 1991;2:112-114.
All the 139 patients subjected to goitre surgery between January 1987 and September 1989 in the DHQ Hospital Rawalpindi were included in the study. There were 128 females and. 11 males and 58 percent of the cases in the age group 11-30 years. Majority of the patients came from Rawalpindi, Murree and adjoining areas. The indications for surgery were cosmetic reasons in 43.8%, pressure symptoms in 38.8% and toxic com­plications in 17.4%, Post-operative transient tetany was encountered in 3 cases only. The histopathological diagnosis was colloid adenomatous goitre in 135 cases, follicular carcinoma in 3 and acute or chronic thyroiditis in one patient. Most of the subjects required hospitalization between 5 and 12 days. A survey was also conducted at the Phagwari and Charhan villages of Murree to observe the incidence of goitre. 157 families turned up for the interview and it was noted that 106 families had one or more of their members affected by goitre. In all 168 goitre cases were detected, of which, 142 were females and 26 were males. 66 percent of these cases were in the age group 11 to 30 years. Goitre was first reported from the regions, now forming northern Pakistan, by Mc Carrison in 1906. From the presented study it is observed that females are more affected than males livingin the northern areas alongwith the Murree hills and adjoining regions. It is thus mandatory that women of child bearing age living in these iodine deficient areas should receive iodized oil injec­tions and along term plan should be proposed to provide iodized salt to the population of these provinces. Iodination of water supply especially in villages can be a solution for the problem which will additionally purify the water.
Effect of Halothane, Enflurane and Isoflurane on the Middle Ear Pressure. Samarrae, S.A., Ukra, H.,Jodah, K. PakJ. Otolaryngol., 1993;9:73-75.
A study was conducted to measure the pressure changes in the middle ear during the use of the anaesthetic agents Halothane, Enflurane and Isoflurane, alongwith the time required to achieve these changes while keeping nitrous oxide concentration constant. Ninety cases scheduled for various ENT surgery were selected for the study. Three groups of3O each were formed who were given one of the three agents alongwith Nitrous oxide and oxygen in the ratio 5:3L/minute. Continuous measurement of middle ear pressure was performed by using tympanometry before induction of anaesthesia. Pressure changes were plotted against time. The mean age of the patients was 13 years with 56 males and 34 females. The induction technique used was inhalation in 30 cases, intravenous in 52 and IPPV in 8 patients, the choice being governed by the age of the individual and length of the surgery. The results of the study showed no statistical difference between the three agents regarding pressure changes. But the peak time of the 3 agents was statistically significant. The Enflurane group had a faster peak pressure than the Halothane group. This was similar for the second peak too. No difference was noted between the Isoflurane and Halothane group. The conclusion drawn from the study was that Enfiurane achieved faster pressure changes in the ear than other agents. Though it has a moderate blood gas solubility coefficient, it increases the pressure more than expected.
Wardenburg Syndrome. Sachdeva, O.P., Gulati, S.P., Kakkar, V., Sachdeva, A. Pakj. Otolaryngol., 1993;9:94-95.
Six affected individuals from two different families are described in the case repons. . it. families ap­proached the department of otolaryngology, Medical College and Hospital, Rohtak, India, for disablement certificates, for being deaf and mute. On detailed interrogation it was found that in family A six individuals were affected in three generations and in family B four were affected in two generations. The oldest was a 35 year old female and the youngest a 5 year old male. All the cases had dystopia canthorum, deafness and mutism, confluent eye brows, broad nasal roots and increased medial intercanthal distance. Isochromia iridis was seen in four cases and partial heterochromia iridis bilateral and unilateral in one case each. Forearm skin pigmenta­tion was noted in the eldest subject only. The syndrome first described by Vander Hoeve in 1916 was reported by Waarderburg in 1948. The prominent features described are lateral displacement of medial canthi, dystopia of the lacrimal puncta and blepharophimosis, prominent broad root of nose, ap­proximation of the eye brows with eterochromia iridis totalis, hypertrichosis, partial albinism and hearing loss. The cases presented are consistent with the Waar­denburg Syndrome. The autosomal dominant in­heritance pattern supports the genetic hypothesis. All the cases showed a higher degree ‘of penetrance of the components than described in the classical syndrome.