Risk factors associated with oral manifestations and oral health impact of gastro-oesophageal reflux disease: a multicentre, cross-sectional study in Pakistan.

Objective: Gastro-oesophageal reflux disease (GORD) is a relatively common disorder and manifests with extraoesophageal symptoms, such as dental erosions (DE), cough, laryngitis, asthma, and oral soft- and hard-tissue pathologies. This study aimed (1) to identify oral soft and hard-tissue changes in patients with GORD and (2) to evaluate these oral changes as indices for assessing GORD and its severity.

Setting: This cross-sectional study was conducted at four major tertiary care government hospitals, in two metropolitan cities of Pakistan.

Association Of Vitamin B12 Deficiency With Intake Of Oral Metformin In Diabetic Patients.

Background: It is estimated that 450 million people worldwide have diabetes mellitus Objective of the study was to determine effect of Metformin on vitamin B12 level among patients with type 2 diabetes mellitus. It is a cross sectional study conducted at Medicine department, Shalamar Hospital Lahore.

Methods: Seventy-two patients of diabetes mellitus were included in the study.

Migratory Gossypiboma: An Unusual Presentation Of A Rare Surgical Complication.

Gossypiboma is a rare surgical complication associated with significant patient morbidity and even mortality. Migratory gossypiboma is a rarer subset of these cases, representing the erosion of surgical sponge into the intestine with consequent complications. A 40 years old female presented with a surgical sponge that had eroded into the caecum and subsequently moved with peristalsis up to the anal canal from which it was protruding out at the time of presentation.

Frequency of foot ulcers in people with type 2 diabetes, presenting to specialist diabetes clinic at a Tertiary Care Hospital, Lahore, Pakistan.

Background: Diabetic foot ulceration is a serious limb-threatening complication of diabetes. It is the common cause of hospital admissions and amputations. The objective of the study was to determine the prevalence of diabetic foot ulcers (DFU) and its association with age, gender, duration of diabetes, peripheral neuropathy (PN), peripheral arterial disease (PAD) and HbA1c.

Primary Jejunal adenocarcinoma - An unsuspected culprit.

Primary Small bowel adenocarcinoma, a rare entity and having varied clinical presentation, makes its clinical detection a diagnostic challenge. Moreover, its true prevalence in sub-continent population has not yet been established, which makes it more difficult for its detection. We present the case of a 60 year old male who came with abdominal pain and weight loss for two years as the only symptoms.

The efficacy of excision followed by intralesional 5-fluorouracil and triamcinolone acetonide versus excision followed by radiotherapy in the treatment of ear keloids: A randomized control trial.

Background: The ear is the common site for keloid formation especially in women after ear piercing. Surgery is the main stay of treatment in these lesions but there are large numbers of treatment failures in surgery alone.

Objective: The objective of this study was to compare the efficacy of post-excision intralesional 5-fluorouracil/triamcinolone acetonide (5-FU/TAC) and post-excision radiotherapy in the treatment of ear keloids.

A Case Of Thrombosis Due To Paroxysmal Nocturnal Haemoglobinuria Presenting At An Early Age.

Paroxysmal Nocturnal Haemoglobinuria (PNH) is an acquired, rare life-threatening disorder characterised by compliment mediated hemolytic anemia, thrombosis and impaired bone marrow function. It occasionally presents in childhood or adolescence. This is a case of a 14-year old female presented with complaints of shortness of breath, palpitation and abdominal pain whose laboratory test results were consistent with Coomb's test negative haemolytic anaemia.

Circadian Variation In The Onset Of Acute Myocardial Infarction In Diabetics.

Background: It has been shown in previous studies there is circadian variation in the onset of acute myocardial infarction. The objective of this study was to evaluate the relation of circadian variation in onset of Acute Myocardial infarction in Diabetic subjects.

Methods: This study was conducted at the Services Institute of Medical Sciences Lahore and Punjab Institute of Cardiology from January 2015 to February 2016.

Dramatic response of hepatitis C patients chronically infected with hepatitis C virus genotype 3 to sofosbuvir-based therapies in Punjab, Pakistan: A prospective study.

Aim: To prospectively evaluate the efficacy of sofobuvir (SOF) in hepatitis C patients infected with hepatitis C virus (HCV) genotype 3 in Pakistan.

Methods: The present study was performed with the coordination of gastroenterology and pathology departments of Shalamar Hospital Lahore from August 2014 to May 2016. The total number of patients included in this study was 1375 and all of them were infected with HCV genotype 3.

Tuberculosis of Open Cholecystectomy Wound.

Tuberculosis of the wound is a rare entity. A50-year lady presented with an "on and off discharging wound" from the postoperative wound site of open cholecystectomy, which was done 7 years ago. Patient did not respond to standard antibiotic treatment regimens; and also the culture remained equivocal during this period.

Levetiracetam Induced Increase in Creatine Phosphokinase Levels.

Levetiracetam is an antiepileptic drug used for the treatment of generalised or partial seizures, either alone or in a combination therapy. Adverse effects have been reported with its clinical use, including headache, dizziness, liver failure etc. A rare but an important adverse effect is an increase in creatine phosphokinase (CPK) levels with its use.

An Unusual Presentation of Opioid Induced Cerebral Infarction.

Opioid induced cerebral infarction is one of the most dreadful complications encountered in clinical practice. A30-year known hypertensive male presented to the emergency department of Shalamar Hospital, Lahore, Pakistan, with altered state of consciousness. He had been in his usual state of health a day before the presentation.

Preload Versus Coload and Vasopressor Requirement for the Prevention of Spinal Anesthesia Induced Hypotension in Non-Obstetric Patients.

Objective: To compare the effectiveness of preload and coload for the prevention of Spinal Induced Hypotension (SIH) and vasopressor requirements.

Study Design: Randomized trial.

Place And Duration Of Study: Department of Anesthesia, The Aga Khan University Hospital, Karachi, Pakistan, from June 2007 - June 2010.

Kikuchi disease.

Kikuchi-Fujimoto Disease or Necrotizing Lymphadenitis is a rare, benign, self-limiting disease. It usually effects young females in the third decade of life. The most common presentation is cervical lymphadenopathy, though the etiology of the disease is still controversial.

Demographic factors affecting quality of life of hemodialysis patients - Lahore, Pakistan.

Objective: The objective of the study was to determine the demographic factors affecting Quality Of Life (QOL) of hemodialysis (HD) patients.

Methods: This observational study was conducted at Shalamar Hospital, Lahore. Patients of End Stage Renal Disease (ESRD) and on maintenance HD for more than three months were included during the period March to June 2012.

Comparison of awareness about nephrology and kidney diseases amongst doctors in institutes with and without nephrology departments.

Objective: To compare the awareness about nephrology and kidney diseases in medical officers and postgraduate trainee doctors working in institutes with and without nephrology departments.

Methods: This cross sectional study was conducted at Nephrology Department, Shalamar Hospital Lahore from 1(st) Jan to 31(st) Mar 2013. Doctors working on medical floor with more than one year experience after house job were included in the study.

Outcome of 7-S, TQM technique for healthcare waste management.

Objective: To assess the present waste management system of healthcare facilities (HCFs) attached with Shalamar Hospital, Lahore by applying the 7-S technique of Total Quality Management (TQM) and to find out the outcome after imparting training.

Study Design: Interventional quasi-experimental study.

Place And Duration Of Study: The Shalamar Hospital, Lahore, Punjab, Pakistan, November, 2009 to November, 2010.

Rupture of membranes in second trimester of pregnancy.

The management of rupture of membranes at a nearly viability stage is still controversial. A case of a primigravida, who had rupture of membranes at 23 weeks of gestation, is reported. On conservative management, her pregnancy continued to 30 weeks and she delivered a normal fetus, who showed no abnormality till one year of follow-up.

Labor management in a patient with von Willebrand disease.

von Willebrand disease (VWD) is an inherited bleeding disorder involving a deficiency or abnormal function of a blood clotting protein called von Willebrand factor (VWF). Deficiency of VWF, therefore, shows primarily in organs with small blood vessels such as the skin, the gastrointestinal tract and the uterus. This case report describes management of a patient presenting with type II von Willebrand disease in labor.

Justifying the clinical use of fresh frozen plasma - an audit.

Objective: To determine the appropriateness of fresh frozen plasma (FFP), uses in various haematological and clinical disorders, with reference to the British Committee for Standards in Haematology (BCSH) guidelines through an audit.

Design: Descriptive study.

Place And Duration Of Study: Department of Haematology and Transfusion Medicine, Shalamar Hospital, Lahore, from June 2001 to June 2004.

Evaluation of nutritional status of patients on haemodialysis.

Objective: To evaluate the nutritional status of patients on haemodialysis for chronic renal failure.

Design: Single center cross-sectional hospital based study.

Place And Duration Of Study: This study was carried out at haemodialysis unit of Shaikh Zayed Hospital, Lahore from March to May 2000.