Asif Hanif

Congenital hypothyroidism in neonates

Context: Congenital hypothyroidism (CH) is one of the most common preventable causes of mental retardation in children and it occurs in approximately 1:2,000-1:4,000 newborns. Aims and Objectives: The aim of this study is to determine the frequency of CH in neonates. Settings and Design: This cross-sectional study was conducted in neonatal units of the Department of Pediatrics Unit-I, King Edward Medical University/Mayo Hospital, Lahore and Lady Willington Hospital Lahore in 6 months (January-June 2011). Materials and Methods: Sample was collected by non-probability purposive sampling. After consent, 550 newborn were registered for the study. Demographic data and relevant history was recorded. After aseptic measures, 2-3 ml venous blood analyzed for thyroid-stimulating hormone (TSH) level by immunoradiometric assay. Treatment was started according to the individual merit as per protocol. Statistical Analysis Used: Data was analyzed by SPSS 17 and Chi-square test was applied to find out the association of CH with different variables. Results: The study population consisted of 550 newborns. Among 550 newborns, 4 (0.8%) newborns had elevated TSH level. CH had statistically significant association with mothers hypothyroidism (P value 0.000) and mothers drug intake during the pregnancy period (P value 0.013). Conclusion: CH is 0.8% in neonates. It has statistically significant association with mothers hypothyroidism and mothers drug intake during pregnancy.

Incidence of Hyperuricemia in Patients of Renal Calculi and Their Comparison with Chemical Analysis of Renal Stones

Distraction osteogenesis popularized by Ilizarov has been the only solution in most of bone defect nonunions but this has never been worked in old fracture neck of femur with resorbed neck. We applied this principle in a young child with old fracture neck of femur with resorbed neck. We applied across hip external fixator and gradual distraction was started. Resorbed neck was completely formed in 06 months and patient regained his normal leg length and mobility and escaped major surgery.

Incidence of Fetal Distress in 6 Hourly Vaginally Administered 3 Doses, of Misoprostol Versus Dinoprostone for Labour Induction: A Comparative Study

Abstract: Background: Artificial labor pain always poses the risk of fetal distress and is more painful than spontaneous labour. The pharmacological agents that are involved in stimulating uterine contraction may initiate a chain of processes that may lead the baby to suffocate, being deficient of essential oxygen and suffer from distress. The accelerated efforts to adapt safe and advanced measures are inevitable to make the labour induction easier and more secure for both lives involved. Objective: The objective of this study was to compare the incidence of fetal distress in 6 hourly vaginally administered 3 doses, of misoprostol versus dinoprostone for labour induction. Methods: This observational type of comparative study was conducted in Obstetrics Ward Lady Aitchison Hospital Lahore. A total of 200 postdate primigravidas undergoing induction of labour at 41 weeks were selected for this study. They were randomly divided into misoprostol and dinoprostone group, each containing 100 patients. The dose of misoprostol was 50 microgram each time up to a maximum of 150 microgram (3 doses) and dose of dinoprostone was 2 mg and only 2 doses of dinoprostone were used with an interval of 6 hours. Continuous fetal heart rate monitoring was done after induction. Signs of fetal distress like meconium staining of liquor after rupture of membranes and CTG changes were noted. After delivery of baby Apgar score at 5 minutes was taken and any resuscitation required or need for keeping the baby in nursery was noted. Results : The mean age of the patients in misoprostol group was 25.4±4.5 years and in dinoprostone group was 23.3±3.4 years. The mean duration of induction to delivery interval in misoprostol group was 16.4±6.4 hours and in dinoprostone group was 13.1±4.6 hours. In misoprostol group, 40 (40%) patients delivered with LSCS and 60 (60%) patients delivered with spontaneous vaginal delivery. In dinoprostone group, 36 (36%) patients delivered with LSCS and 64 (64%) patients delivered with spontaneous vaginal delivery. The mean Apgar score at 5 minutes in misoprostol group was 8.5±0.9 and in dinoprostone group was 8.6±0.9. In misoprostol group, there were 5 (5%) patients who were admitted in intensive care unit and in dinoprostone group 2 (2%) patients were admitted in intensive care unit. Conclusion: It is concluded from this study that the incidence of fetal distress did not increase when compared to dinoprostone when misoprostol is used at the dose of 50 mcg for induction of labour without decreasing its efficacy regarding induction and delivery. Key Words: Fetal distress, induction of labour, misoprostol, dinoprostone.

Evaluation of the Treatment of Frozen Shoulder by Hydraulic Distention Under

Results: The average age of patients in group I was 52 ± 2.16 years and 50 ± 2.03 in group II. There were 37 (63%) females and 22 (37%) males in our study. Female to male ratio was 1.7:1. All patients in group-I noted immediate pain relief with excellent return of range of motion (ROM) and resumption of normal sleep. At the end of 45 days of follow up all patients had returned to their normal daily activities. Most of them got excellent ROM and pain relief. All patients in group-II noted immediate pain relief and resumption of almost normal sleep. At the end of 45 days of follow up most of the patient presented with good relief of pain but could not return to most of their normal activities because of less improvement in ROM.

Occupational Hand Injuries Presenting at Accident and Emergency Department / Mayo Hospital Lahore. A Review of Six Months

Distraction osteogenesis popularized by Ilizarov has been the only solution in most of bone defect nonunions but this has never been worked in old fracture neck of femur with resorbed neck. We applied this principle in a young child with old fracture neck of femur with resorbed neck. We applied across hip external fixator and gradual distraction was started. Resorbed neck was completely formed in 06 months and patient regained his normal leg length and mobility and escaped major surgery.

Healing of Posterior Transverse Ankle Incision with Medial Fasciocutaneous Flap for Club Foot Surgery

Distraction osteogenesis popularized by Ilizarov has been the only solution in most of bone defect nonunions but this has never been worked in old fracture neck of femur with resorbed neck. We applied this principle in a young child with old fracture neck of femur with resorbed neck. We applied across hip external fixator and gradual distraction was started. Resorbed neck was completely formed in 06 months and patient regained his normal leg length and mobility and escaped major surgery.