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Objective: To determine the etiological pattern, clinical presentation and outcome of patients with proptosis in a tertiary care hospital. Study Design: Cross-sectional study. Place and Duration of Study: Ophthalmology Department, Khyber Teaching Hospital, Peshawar Pakistan, from Jan 2019 to Jun 2020. Methodology: This study was conducted on 60 patients having proptosis. Patients were treated either medically, surgically or both. The demographic profile included age, gender and type of proptosis. The outcome included recovery, re-treatment, referral to the relevant speciality and loss to follow-up, were measured. Results: Out of 60 patients with proptosis, 39 were males, and 21 were female. Fifty-two patients had unilateral, and 8 had bilateral proptosis, with the majority suffering from non-axial proptosis. On aetiology exhibited tumours (45%), infectious (25%), inflammatory (16.6%), vascular (6.66%) and injury (6.66%). The surgical procedure was indicated in 27(45%) patients, while medical treatment was given in 28(46.6%) patients. Five patients (8.4%) received both surgical and medical treatment. Out of 60 patients, 26 patients (46.33%) fully recovered and 11 patients (18.33%) did not recover, 17(28.33%) patients were referred to other specialities for management, and 5(8.3%) patients lost to follow-up. Conclusion: In our study, tumours were the main cause of proptosis, followed by infective and inflammatory causes, with the paediatric age group (<18 years) at more risk. [ABSTRACT FROM AUTHOR]

Background: Cancer patients are considered as highly vulnerable individuals in the current COVID-19 pandemic. We studied the clinical characteristics of survivor and non-survivor COVID-19-infected cancer patients in Pakistan. Patients and Methods: We did a retrospective study of 70 cancer patients with PCR-confirmed COVID-19 infection from Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore and Peshawar, Pakistan between April 13 and July 09, 2020. These patients were discharged from the hospital or had died by July 09, 2020. Clinical, pathological and radiological characteristics were compared between survivors and non-survivors by fisher's exact test and chi-square test. Univariable and multivariable logistic regression models were performed to explore the risk factors of mortality. Results: Seventy cancer patients with SARS-CoV-2 infection were enrolled and the majority were males 38 (54.3%). 57 (81.4%) had solid tumors and 13 (18.6%) had hematological malignancies. Dyspnea (44 cases) was the most common symptom (62.9%). Complications were reported in 51 (72.9%) patients during the course of disease. 19 (27.1%) patients were admitted to an intensive care unit (ICU). A significant increase in the C-reactive protein level and neutrophil count was observed in the deceased patients as compared to the surviving patients. D-dimer values of ≥0.2 mg/L were significantly associated with mortality (P =0.01). We identified two independent risk factors associated with death, ICU admission (P =0.007) and D-dimer (P =0.003). Conclusion: Pakistani cancer patients with COVID-19 infection reported poor prognosis. Intensive surveillance of clinicopathological characteristics of cancer patients infected with COVID-19 especially D-dimer values may play a pivotal role in the outcome of the disease. [ABSTRACT FROM AUTHOR]

Objectives: To know about the findings on fundoscopic examination in patients complaining of primary headache presenting to the Neurosurgical Outpatient Department (OPD). Study Design: Cross sectional study. Setting: Neurosurgery unit of Govt. Naseer Ullah Babar Memorial Hospital, Kohat Road, Peshawar. Period: December 2016 to December 2017. Materials and Methods: All patients presenting to the Neurosurgical OPD with complaints of headache on whom a fundoscopy was done, were included in the study. The age, gender, duration of symptoms, findings on the fundoscopy, and the need for further studies i.e. CT brain, were noted on a proforma. Any positive findings on fundoscopy were further referred to and evaluated by an ophthalmologist under the slit lamp. All patients with history of recent trauma, focal neurological deficit, and those who had undergone brain imaging were excluded from the study. Consent was taken from all the patients. The data was analyzed by SPSS version 19, and was expressed in the form of tables and charts. Results: A total of 19,000 patients were evaluated in the Neuro-OPD during study period, and 1086 patients were having headache. Majority of the patients were females with a number of 619 (56.99%), while 447(43.01%) were males. The male to female ratio was approaching 1.38:1. Age range was from 9 to 62 years and the mean age was 37 years. Duration of symptoms was from 20 days to 12 years with a mean duration of 9 months. Positive findings were noted in a minority of patients, 2.5% (n=28); including pappiledema, diabetic and hypertensive changes. Subsequent Brain imaging was done in 93(8.5%) patients, majority of them were on patients' request, and only 7 patients were having an intracranial lesion. Conclusion: A minority of patients with headache without any neurology had intracranial lesion. However, the importance of fundoscopy cannot be overruled, and should be performed in every patient with headache. [ABSTRACT FROM AUTHOR]

Objective: This study was done to determine the sensitivity and resistance pattern to the most common antibiotics in use. Methodology: The data for this retrospective study was obtained and analysed from October 2010 to October 2011 in Lady Reading Hospital, Peshawar. Purposive sampling and univariate analysis was done. 2058 samples were cultured for sensitivity using Kirby Bauer's Diffusion technique and in a period of one year, growth of Staphylococcus aureus was obtained in 723 samples. These 723 growths were obtained from clinical isolates of pus (699), blood (16) and urine (8). Fourteen drugs from five different classes of antibiotics were tested for sensitivity against Staphylococcus aureus. Results: Most of the growth was obtained from pus (96.7%). Resistance was high to all groups of antibiotics except glycopeptides. There was no case of Vancomycin Resistant Staphylococcus aureus (VRSA). Out of 723 samples, 228 (31.5%) were Methicillin Resistant Staphylococcus aureus (MRSA). The resistance to a representative antibiotic of each group is as follows: Ciprofloxacin (Fluoroquinolone) 51.7%, Cephradine (Cephalosporin) 46.2%, Amoxicillin+Clavulanic Acid (Penicillin group) 45.6%, Imipenem+Cilastatin Sodium (Carbapenem) 42.0% and Teicoplanin (Glycopeptide) 19.8%. Conclusion: Resistance of Staphylococcus aureus to Teicoplanin and most of the antibiotics is high and strict guidelines are required to control unnecessary prescriptions and over the counter sale of antibiotics. [ABSTRACT FROM AUTHOR]

Objective: Polio is a viral disease that may cause paralysis and infant death. Despite ongoing efforts, polio has not been eradicated from Pakistan. The purpose of this survey is to estimate the coverage of polio vaccine during National Immunization Days and to determine the factors associated with lack of immunization. Methodology: A Cross-sectional survey was conducted in Peshawar, Pakistan, from 1st June to 9th June 2010. Confidence level of 95% and confidence interval of 4 was used to derive the sample size (for a population more than 20,000). Parents of 600 children under 5 years were asked about immunization during NIDs of January -May 2010 (5 NIDs). Questions regarding demographics, income, education, occupation, accessibility to health centres and frequency of visits from health workers was inquired. Knowledge and views on immunization were also asked. 40 health personnel involved in immunization were also interviewed and they were asked about hurdles faced in immunization. Results: 83.7% children were vaccinated in all National Immunization Days, while 94.7% had at least, taken polio vaccine once. 5.3% had not taken polio vaccine during National Immunization Days of 2010. Main reasons for not vaccinating were; Vaccinator absent/not visiting home/vaccine not available (63.36%), no awareness (17.4%), Child ill (5.8%), family problem/mother busy (3.3%) and wrong ideas/sterility (3.3%). Many health personnel (32.5%) considered lack of awareness among people and low accessibility to vaccine as the main hurdles in immunization, besides the poor salaries and incentives. Conclusion: Polio vaccination during National Immunization Days 2010 was a partial success because some pockets of poor children and afghan refugees were poorly vaccinated. In order to eradicate polio, they must be vaccinated. [ABSTRACT FROM AUTHOR]